Operator`s Instruction Manual

Transcription

Operator’s
Instruction
Manual
Part Number: 4117102-005
Rev: —
Fabius GS Software Version 1.3n
Date: 12 September 2003
© 2003 Draeger Medical, Inc.
Fabius GS®
Warning: For a full understanding of the performance of this anesthesia machine,
the user should carefully read this manual before operating.
Contents
Chapter 1. Introduction
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operator’s Responsibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Safety Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Copyright, Trademark, and Limitation of Liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Symbol Definition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Abbreviations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
General Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
3
3
4
4
4
5
8
9
Chapter 2. Configurations and Components
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Typical Fabius GS Configuration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Chapter 3. Operating Concept
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Standard Function Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cross-Functional Controls and Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fresh Gas Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fresh Gas Flow Monitoring Resolutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
APL Valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
17
17
18
20
24
33
34
35
Chapter 4. Preparation
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Activating the Battery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gas Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Medical Gas Pipeline Supply of O2, N2O, and AIR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cylinders with Pin-index Mounting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Electrical Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Attaching Manual (Ambu) Ventilation Bag. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Preparing the Ventilator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ventilator Safety Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Attaching the CO2 Absorber onto the Compact Breathing System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Attaching the Inspiratory Valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Attaching the Expiratory Valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Attaching the Adjustable Pressure Limiting (APL) Valve. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inserting the Flow Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Attaching the Waste Gas Outlet Port. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the Compact Breathing System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the Breathing Hoses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inserting A New O2 Sensor Capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the O2 Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the Pressure Sensor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the Breathing Pressure Gauge. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting the APL Bypass and Peep/PMAX Hoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
37
39
39
39
40
41
41
42
42
43
43
43
44
44
44
45
46
46
47
47
48
48
i
Contents
Connecting the Flow Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Installing Anesthetic Gas Scavenging Hose to the Compact Breathing System . . . . . . . . . . . . . . . . . . . .
Scavenger System for Fabius GS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Additional Equipment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Daily and Preuse Checkout Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
49
49
50
50
50
Chapter 5. Operation and Shut-down
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Operation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Preparation for Transport or Storage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Chapter 6. Monitoring
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Oxygen Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Respiratory Volume Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Breathing Pressure Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
63
65
65
66
72
77
Chapter 7. Setup Window (Used During Operation)
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Setup Window Access. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Auto Set. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Calibrate O2 Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Activate Des Comp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Access Alarm Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Access Alarm Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Window Deactivation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
83
85
85
86
86
87
88
88
88
Chapter 8. Standby Mode Functions
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Standby Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Standby Setup Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
89
91
91
95
Chapter 9. Routine Maintenance and Cleaning
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Routine Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disassembling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disinfecting/Cleaning/Autoclaving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Maintenance Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Checking Readiness for Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
105
107
107
109
111
111
Chapter 10. Troubleshooting
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
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Contents
Chapter 11. Components
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Front View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Compact Breathing System (Top View) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rear View (3-Gas Supply Connections) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
117
119
120
121
Chapter 12. Technical Data
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Technical Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Diagrams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Appendix. Daily and Preuse Checkout Form
iii
Chapter 1 - Introduction
Contents
Introduction
Contents
Overview ................................................................................................................... 3
Recommendations .................................................................................................. 3
Not for Use in Areas of Explosion Hazard .............................................................. 3
Safe Connection with Other Electrical Equipment .................................................. 3
Operator’s Responsibility .......................................................................................... 3
Intended Use ............................................................................................................. 4
Safety Features ......................................................................................................... 4
Copyright, Trademark, and Limitation of Liability ...................................................... 4
Copyright ................................................................................................................ 4
Trademark Notices ................................................................................................. 4
Limitation of Liability ............................................................................................... 4
Symbol Definition ...................................................................................................... 5
Abbreviations ............................................................................................................. 8
Part Number: 4117102-005 Rev: —
General Warnings and Cautions ............................................................................... 9
Fabius GS Operator’s Manual
1
Overview
Overview
Caution: For your safety and that of your patients,
strictly follow this instruction manual.
Any use of the Fabius GS® requires full understanding
and strict observation of these instructions. The unit is
only to be used for purposes specified here.
Recommendations
Because of the sophisticated nature of Draeger
Medical anesthesia equipment and its critical
importance in the operating room setting, it is highly
recommended that only appropriately trained and
experienced professionals, using authentic Draeger
Medical spare parts, be permitted to service and
maintain this equipment. Please contact DrägerService
at (800) 543-5047 or (215) 721-5402 for service of this
equipment.
Draeger Medical also recommends that its anesthesia
equipment be serviced at six-month intervals. Periodic
Manufacturer's Certification Agreements are available
for equipment manufactured by Draeger Medical. For
further information concerning these agreements,
contact DrägerService at (800) 543-5047 or (215) 7215402.
Not for Use in Areas of Explosion Hazard
The Fabius GS is neither approved nor certified for use
in areas where combustible or explosive gas mixtures
are likely to occur. To avoid explosion hazards,
flammable anaesthetic agents such as ether and
cyclopropane or other flammable substances must not
be used in this machine. Only anaesthetic agents that
comply with the requirements on non-flammable
anaesthetic agents in the IEC Standard, Particular
requirements for the safety of anaesthetic machine,
are suitable for use in this machine.
Safe Connection with Other Electrical
Equipment
Electrical connections to equipment which are not
listed in these Instructions for Use should only be
made following consultations with the respective
manufacturers or an expert and shall be in compliance
with national medical device regulations.
Operator’s Responsibility
The equipment design, the accompanying literature,
and the labeling on the equipment take into
consideration that the purchase and use of the
equipment are restricted to trained professionals, and
that certain inherent characteristics of the equipment
are known to the trained operator. Instructions,
warnings, and caution statements are limited,
therefore, to the specifics of the Draeger Medical, Inc.
design. This publication excludes references to
hazards which are obvious to a medical professional,
to the consequences of product misuse, and to
potentially adverse effects in patients with abnormal
conditions. Product modification or misuse can be
dangerous. Draeger Medical, Inc. disclaims all liability
for the consequences of product alterations or
modifications, as well as for the consequences which
might result from the combination of Draeger Medical,
Inc. products with products supplied by other
manufacturers if such a combination is not endorsed
by Draeger Medical, Inc.
The operator of the anesthesia system must recognize
that the means of monitoring and discovering
hazardous conditions are specific to the composition of
the system and the various components of the system.
It is the operator, and not the various manufacturers or
suppliers of components, who has control over the final
composition and arrangement of the anesthesia
system used in the operating room. Therefore, the
responsibility for choosing the appropriate safety
monitoring devices rests with the operator and user of
the equipment.
The Fabius GS is equipped to monitor breathing circuit
pressure, exhaled volume and inspired oxygen, and to
sound an alarm when any of these parameters violates
a preset limit. The Fabius GS should not be used if any
of these monitors are not functioning properly. Draeger
Medical, Inc. also recommends that the Fabius GS
only be used to deliver anesthesia and/or mechanical
ventilation in accordance with the guidelines for patient
monitoring published by the American Society of
Anesthesiologists. In addition to volume, pressure, and
oxygen monitoring, these guidelines require the use of
a capnometer to monitor inspired and expired carbon
dioxide as well as other patient monitors including
continuous electrocardiography, pulse oximetry, and
arterial blood pressure monitoring. Anesthetic agent
monitoring and temperature monitoring are also
strongly recommended. The responsibility for the
selection of the best level of patient monitoring belongs
solely to the equipment operator. To this extent, the
manufacturer, Draeger Medical, Inc., disclaims
responsibility for the adequacy of the monitoring
package selected for use with the anesthesia system.
However, Draeger Medical, Inc. is available for
consultation to discuss monitoring options for different
applications.
3
Restriction
Caution: Federal law and regulations in the United
States restrict this device to sale by, or on
the order of, a physician.
Intended Use
Caution: Do not use mobile phones within a distance
of 10 meters from the machine. Mobile
phones can cause malfunctions in electrical
medical equipment, thereby endangering
the patient and the operator.
Intended Use
Fabius GS is an inhalation anesthesia machine for
use in operating, induction and recovery rooms.
It may be used with O2, N2O, and AIR supplied by a
medical gas pipeline system or by externally mounted
gas cylinders.
Fabius GS is equipped with a compact breathing
system, providing fresh gas decoupling, PEEP, and
pressure limitation.
The following ventilation options are available:
•
•
•
•
Volume Controlled Ventilation
Pressure Controlled Ventilation
Manual Ventilation
Spontaneous Breathing
Fabius GS is equipped with an electrically driven and
electronically controlled ventilator and monitors for
airway pressure (P), volume (V), and inspiratory
oxygen concentration (FiO2).
As per EN740 (Anesthetic Workstations and their
Modules- Particular Requirements), additional
monitoring of the concentrations of CO2 and anesthetic
agent is required when the machine is in use.
Do not use readily flammable anesthetic agents
such as ether, cyclopropane, etc.
• Monitoring of P, V, FiO2
• O2 SUPPLY LOW alarm
• Integrated S-ORC = Sensitive Oxygen Ratio
Controller (control device to ensure minimum
O2 concentration of 23 Vol.%).
Per EN740, burns may occur if antistatic or electrically
conductive ventilation tubes are used in combination
with high-frequency electrical surgery equipment.
Therefore, per EN740, these types of breathing tubes
are not recommended.
Caution: Do not use Fabius GS in the environment
of NMR tomography equipment.
Malfunctions may result, thereby
endangering the patient.
4
Copyright
Copyright 2002 by Draeger Medical, Inc. All rights
reserved. No part of this publication may be
reproduced, transmitted, transcribed, or stored in a
retrieval system in any form or by any means,
electronic or mechanical, including photocopying and
recording, without written permission of Draeger
Medical, Inc. The exceptions to this are
“Recommendations for Typical Cleaning and
Disinfection After Use” on page 110 and “Daily and
Preuse Checkout Form” in Appendix A.
Trademark Notices
DrägerService, Fabius GS, and Vitalink are registered
trademarks of Draeger Medical, Inc. Fabius and Vapor
are registered trademarks of Dräger. All other products
or name brands are trademarks of their respective
owners.
Limitation of Liability
Draeger Medical, Inc.'s liability, whether arising from or
related to the manufacture and sale of the products,
their installation, demonstration, sales representation,
use, performance, or otherwise, including any liability
based upon Draeger Medical, Inc.'s product warranty,
is subject to and limited to the exclusive terms of
Draeger Medical, Inc.'s limited warranty, whether
based upon breach of warranty or any other cause of
action whatsoever, regardless of any fault attributable
to Draeger Medical, Inc. and regardless of the form of
action (including, without limitation, breach of warranty,
negligence, strict liability, or otherwise).
Draeger Medical, Inc. shall in no event be liable for any
special, incidental, or consequential damages
(including loss of profits) whether or not foreseeable
and even if Draeger Medical, Inc. has been advised of
the possibility of such loss or damage. Draeger
Medical, Inc. disclaims any liability arising from a
combination of its product with products from another
manufacturer if the combination has not been
endorsed by Draeger Medical, Inc.. Buyer understands
Safety Features
Copyright, Trademark, and
Limitation of Liability
Symbol Definition
that the remedies noted in Draeger Medical Inc.'s
limited warranty are its sole and exclusive remedies.
Furthermore, buyer acknowledges that the
consideration for the products, equipment, and parts
sold reflects the allocation of risk and the limitations
of liability referenced herein.
Symbol Definition
The following symbols appear on the labels on the
back of the Fabius GS and are defined below.
Caution: Refer to accompanying documents
!
before operating equipment.
Caution: Risk of electric shock, do not remove
cover. Refer servicing to a
DrägerService representative.
Degree of protection against electric shock: Type B.
Registration Mark
C
US
Year Manufactured
The following symbols appear on the shipping
container of the Fabius GS.
This end up.
Handle with care.
Keep dry.
5
Symbol Definition
Minimum and maximum storage temperatures.
60°c
-10°c
DRAGER
MEDICAL,
INC
The following symbols are used on other locations of
the Fabius GS to provide quick and easy recognition
of product functions.
Quarry Road
Telford, PA 18969
TITLE
AW - LOGO - PACKAG
DRAWN BY
SAG
APPROVED BY ARTWORK NO
DLB
DATE 11-28-00 DATE 12-05-00
Oxygen Concentration Sensor Port
Breathing Pressure Sensor Port
Breathing Volume Sensor Port
Ventilator Port
Pipeline, Gauge, Pipeline Inlet
Breathing Bag
Flowmeter Level Indicator
Indicates Direction
6
AW41150
Symbol Definition
Total Power Applied
Partial Power Applied
Cylinder Gauge, Remote Cylinder Inlet
Do Not Oil
The following symbols are used on the Fabius GS
monitoring user interface.
Table Top Light
Upper and Lower Alarm Limits
Return to Home Screen
Suppress Alarm Tone for Two Minutes
Standby Mode
Available Operating Capacity of UPS
Close Menu, Back to Previous Menu
7
Abbreviations
Upper Alarm Limit
Lower Alarm Limit
Mains Applied/Mains Power
Alarm Off
Setup Screen
Abbreviations
Meaning
FLOW
Expiratory flow
FiO2
Inspiratory O2 concentration
MAN
Manual ventilation
MEAN
Mean (airway) pressure
N2O
Nitrous Oxide
O2
Oxygen
PAW
Airway pressure
PEAK
Peak (airway) pressure
PEEP
Positive end-expiratory pressure
PLAT
Plateau airway pressure
Pmax
Maximum (airway) pressure setting
SPONT
Spontaneous breathing
TI : TE
Ratio of inspiratory to expiratory time
Tip : Ti
Ratio of inspiratory pause time to inspiratory time
UPS
Uninterruptible power supply
VAC
Vacuum (e.g., for secretion aspiration)
VT
Tidal volume
8
Abbreviation
General Warnings and Cautions
The following list of warnings and cautions apply to
general operation and maintenance of the
Fabius GS. Warnings and cautions about installing and
operating specific parts appear with those topics.
•
•
Warning statements give important information
that, if ignored, could lead directly to a patient's
or operator's injury.
Caution statements give important information
that, if ignored, could lead directly to equipment
damage and, indirectly, to a patient's injury.
Warning: Any person involved with the setup,
operation, or maintenance of the
Fabius GS anesthesia system must be
thoroughly familiar with this instruction
manual.
Warning: This anesthesia system will not respond
automatically to certain changes in patient
condition, operator error, or failure of
components. The system is designed to be
operated under the constant surveillance
and control of a qualified operator.
Warning: No third-party components shall be
attached to the anesthesia machine,
ventilator, or breathing system (except for
certain approved exceptions). For more
information, contact your local Authorized
Service Organization or DrägerService at:
DrägerService
Draeger Medical, Inc.
3122 Commerce Drive
Telford, PA 18969
Tel: (215) 721-5402
(800) 543-5047
Fax: (215) 721-5784
Warning: Each institution and user has a duty to
independently assess, based on its, his, or
her unique circumstances, what
components to include in an anesthesia
system. However, Draeger Medical, in the
interest of patient safety, strongly
recommends the use of an oxygen
analyzer, pressure monitor, volume
monitor, and end-tidal CO2 monitor in the
breathing circuit at all times.
Warning: When moving the anesthesia machine,
remove all monitors and equipment from
the top shelf and use only the machine
handles or push/pull bars. The anesthesia
machine should only be moved by people
who are physically capable of handling its
weight. Draeger Medical recommends that
two people move the anesthesia machine
to aid in maneuverability. Exercise special
care so that the machine does not tip
when moving up or down inclines, around
corners, and across thresholds (for
example, in door frames and elevators).
Do not attempt to pull the machine over
any hoses, cords, or other obstacles on
the floor.
Warning: Apply the caster brakes when the
anesthesia machine is in use.
Caution: Although the Fabius GS is designed to
minimize the effects of ambient radiofrequency interference, machine functions
may be adversely affected by the
operation of electrosurgical equipment or
short wave or microwave diathermy
equipment in the vicinity.
Caution: Communications with external equipment
may be temporarily affected by
electromagnetic interference due to the
use of electrosurgical equipment.
Caution: Do not place more than 40 pounds on top
of the Fabius GS monitor housing.
Caution: Never allow the battery to completely
discharge. If the battery does discharge
completely, recharge immediately.
Caution: Front GCX rails have a maximum
accessories weight load of 5 lb./2.3 kg,
extended out at 3 in./7.6 cm from the rail,
at any position on the rail.
9
Option
Weight
Fabius GS
Back Left Side
Accessory Option
30 lb. / 13.6 kg
28 lb. / 12.7 kg
26 lb. / 11.8 kg
24 lb. / 10.9 kg
22 lb. / 10.0 kg
20 lb. / 9.1 kg
Caution: Possible Tip Over
Hazard If Mounting Accessories
Exceed Approved Limits.
18 lb. / 8.2 kg
Approved
Mounting Limits
Option
16 lb. / 7.3 kg
Weight
14 lb. / 6.4 kg
12 lb. / 5.4 kg
10 lb. / 4.5 kg
15.0 in.
38.1 cm
10.0 in.
25.4 cm
5.0 in.
12.7 cm
Mount Arm Length
Option
Weight
Fabius GS
Back Right Side
Accessory Option
60 lb. / 7.2 kg
55 lb. / 24.9 kg
50 lb. / 22.7 kg
40 lb. / 18.1 kg
35 lb. / 15.9 kg
30 lb. / 13.6 kg
25 lb. / 11.3 kg
Approved
Mounting Limits
Caution: Possible Tip Over
Hazard If Mounting Accessories
Exceed Approved Limits.
MAXIMUM WEIGHT
PER ARM 30 lb.
COMBINED MULTIPLE
ARM WEIGHTS NOT
TO EXCEED 60 lb. MAX.
20 lb. / 9.1 kg
15 lb. / 6.8 kg
10 lb. / 4.5 kg
5.0 in.
12.7 cm
10.0 in.
25.4 cm
15.0 in.
38.1 cm
Mount Arm Length
10
45 lb. / 20.4 kg
Chapter 2 - Configurations and Components
Contents
Configurations and Components
Contents
Typical Fabius GS Configuration ............................................................................. 13
Components ............................................................................................................ 13
Vaporizers (Optional) ............................................................................................ 13
Dräger Vapor® Interlock System (Optional) .......................................................... 13
Selectatec™* (Optional) ........................................................................................ 14
11
Typical Fabius GS Configuration
Typical Fabius GS Configuration
The Fabius GS Inhalation Anesthesia Machine is a
modular system consisting of a basic gas-delivery
module with a variety of components and
configuration designs to meet the requirements of
various anesthesia delivery applications.
•
•
•
Figure 1. Fabius GS Anesthesia Machine
2-gas version (O2 and Air)
3-gas version (O2, N2O, and Air)
pin index cylinder yokes and pressure gauges
Components
Vaporizers (Optional)
Figure 2. Dräger Vapor System
The Dräger Vapor® anesthetic agent vaporizers (1 in
Figure 2) are used to enrich the fresh gas with a
precisely metered quantity of vapor from the liquid
anesthetic agent being used, i.e. Isoflurane,
Halothane, Enflurane, or Sevoflurane.
When using a third-party Desflurane vaporizer:
220 V Mains
Devapor*
110 V Mains
D-Tec*
1
1
* Devapor and D-Tec are available through your local Desflurane
representative.
Dräger Vapor® Interlock System
(Optional)
Figure 3. Dräger Vapor Interlock System
The Fabius GS is configured for two vaporizers. An
interlock system is used to ensure only one vaporizer
can be used at a time.
Note that the selector lever (1 in Figure 3) is shown in
the center position. This ensures that both vaporizers
are in the locked position. Also, this is the
recommended position for the selector lever when
moving the Fabius GS.
OP00520
1
Moving the selector lever away from the desired
vaporizer allows that vaporizer to be utilized and the
other to be locked out of use.
13
Components
Selectatec™* (Optional)
The interlock system for the Selectatec is built into
the vaporizers. When a vaporizer is selected for use,
the interlocking index pins will protrude from the
sides of the vaporizer thereby not allowing the
neighboring vaporizer to be opened. For more
specific information on the Selectatec, refer to the
Selectatec Vaporizer’s instruction manual.
*Selectatec™ is a registered trademark of Datex-Ohmeda.
14
Chapter 3 - Operating Concept
Contents
Operating Concept
Contents
Overview ................................................................................................................. 17
Standard Function Controls ..................................................................................... 17
Home Key ............................................................................................................. 17
Mains Power Applied LED .................................................................................... 17
Selecting and Confirming ..................................................................................... 17
Tabletop Light Key ................................................................................................ 17
Cross-Functional Controls and Displays ................................................................. 18
Key LED Indicators ............................................................................................... 18
Setup Key ............................................................................................................. 18
Status Bar ............................................................................................................. 19
Monitoring ................................................................................................................ 20
Monitoring Controls .............................................................................................. 20
Monitoring Windows ............................................................................................. 21
Selecting/Setting Monitoring Functions ................................................................ 22
Ventilation ................................................................................................................ 24
Ventilation Controls ............................................................................................... 24
Ventilator Compliance Compensation .................................................................. 24
Ventilation Screens ............................................................................................... 25
Changing Ventilation Modes ................................................................................. 28
Selecting/Setting Ventilation Parameters ............................................................. 32
Fresh Gas Control ................................................................................................... 33
Fresh Gas Flow Monitoring Resolutions ................................................................. 34
Standard Resolution ............................................................................................. 34
High Resolution .................................................................................................... 34
APL Valve ................................................................................................................ 35
15
Overview
Overview
This chapter provides an overview of the user
interface, which enables you to set and view
monitoring, ventilation, and status information using
the respective screens, windows, keys, soft keys,
and the rotary knob. See “Monitoring” on page 63 for
more information.
Standard Function Controls
Figure 4. Ventilation Monitor Screen and System Controls
Home Key
The Home key (1 in Figure 4) displays the main
screen (the screen in Figure 4) from anywhere in the
system.
1
Mains Power Applied LED
The Mains Power Applied LED (2 in Figure 4), when
illuminated, indicates that the machine is connected
to a Mains power source.
2
4
3
Selecting and Confirming
The rotary knob (3 in Figure 4) is used to select and
confirm functions by:
•
Turning (Select)
Turning the rotary knob
•
moves the cursor over the system
operating parameters or
•
changes the value of a parameter that has
been confirmed for adjustment.
Note: This function is indicated in the examples
and instructions of this manual by
“select.”
•
Pressing (Confirm)
Pressing the rotary knob either
•
confirms the system operating parameter
to be adjusted or
•
confirms the change to the selected
operating parameter.
Note: This function is indicated in the examples
and instructions of this manual by
“confirm.”
Tabletop Light Key
The Tabletop Light key (4 in Figure 4) turns on the
tabletop light.
17
Cross-Functional Controls and
Displays
Cross-functional controls and displays are used for
both monitoring and ventilation functions.
Cross-Functional Controls and Displays
1
Key LED Indicators
2
LED indicators (1 in Figure 5) within keys (Volume
Control, Pressure Control, Man/Spont, Alarm
Silence, and Standby) illuminate when that mode or
3
function is selected and operating.
Setup Key
Figure 6. Setup Window
The Setup key is 2 in Figure 5.
Pressed During A Ventilation Mode
The Setup window (1 in Figure 6) replaces the
Waveform area (3 in Figure 5).
The Setup window enables you to
•
perform ventilation functions and
•
view and change monitoring settings.
1
Pressed During Standby Mode
Figure 7. Standby Setup Screen
18
The Standby Setup screen (Figure 7) appears. The
Standby Setup screen enables you to define site
defaults and configuration.
Cross-Functional Controls and Displays
Status Bar
The following numbers in parenthesis refer to
Figure 8.
Figure 8. Status Bar
1
2
3
4
Mode Display (1)
Displays the active ventilator mode.
Alarm Silence Status (2)
Displays the time remaining for alarm silence when
the Silence Alarms key is pressed.
Battery Power Level (3)
Displays the status of the reserve power.
Time (4)
Displays the time.
19
Monitoring
Monitoring
Monitoring Controls
LED Indicators
3
LED lamps (1 in Figure 9) in the upper right corner of
the control panel indicate the degree of urgency of
currently active alarms.
•
Warning — Red Blinking
•
Caution — Yellow Blinking
•
Advisory — Yellow Continuous
4
1
2
Silence Alarms Key
The Silence Alarms key (2 in Figure 9) silences all
active alarm tones for 2 minutes. It resets the silence
time for two minutes each time the key is pressed.
Alarm Limit Key
Figure 10. Alarm Limit Configure Window
The Alarm Limit key (3 in Figure 9) displays the
Alarm Limits window (1 in Figure 10), which appears
in the same location on all mode screens.
Setup Key
The Setup key (4 in Figure 9) is a cross-functional
control. See “Setup Key” on page 18.
1
20
Monitoring
Monitoring Windows
The following numbers in boldface refer to
Figure 11.
Figure 11. Monitor Screen
1
2
Alarm Window
The Alarm window (1) displays up to four of the
highest priority alarms.
3
Oxygen Monitor Window
4
The Oxygen Monitor window (2) displays the
inspiratory oxygen concentration in units of percent
(%). It also displays the oxygen alarm limits in the farright section of this window.
5
Respiratory Volume Monitor Window
The Respiratory Volume Monitor window (3) displays
the patient's frequency (breaths per minute) or
respiratory rate, tidal volume, minute volume, the
minute volume high alarm limit, and the minute
volume low alarm limit.
Breathing Pressure Monitor Window
The Breathing Pressure Monitor window (4) displays
the patient's positive end expiratory pressure
(PEEP), mean airway pressure (MEAN) or plateau
airway pressure (PLAT), and peak airway pressure
(PEAK).
Breathing Pressure Trace Window
The Breathing Pressure Trace window (5) displays a
trace, or waveform, of the patient's breathing
pressure.
21
Selecting/Setting Monitoring Functions
Monitoring
Figure 12. Standby Screen
The following example describes changing alarm
limits on the Standby Setup Screen.
Example
1. Press the Setup key while the Standby Screen
(Figure 12) is active. The Standby Setup screen
(Figure 13) replaces the Standby Screen.
2. The rotary knob enables you to select the
“Default Settings” or “Configuration” label.
Select and confirm the “Default Settings” label.
The Default Settings column is selected
(Figure 14).
Note: Selecting and confirming the return arrow
(1 in Figure 13) will deactivate the Standby
Setup screen and activate the Standby
screen (Figure 12).
Note: Selecting and confirming the return arrow
(1 in Figure 14) will deselect the Default
Settings column and reselect the Default
Settings label as in Figure 13.
1
1
22
Figure 14. Standby Setup Screen Default Settings Selected
Monitoring
3. Select and confirm the “Alarm Limits” label.
Figure 15. Standby Setup Screen Default Alarm Limits
The Default Alarm Limits window appears
(1 in Figure 15).
1
4. Select the alarm limit value that needs to change
(Figure 16).
Select
5. Confirm the alarm limit value and select a new
value for the alarm limit (ex., in Figure 17, the
value was changed from 30 to 25).
Confirm
6. Confirm the new value for the alarm limit.
The new alarm limit value is saved and the cursor
moves over the return arrow.
23
Ventilation
Ventilation
Ventilation Controls
The following numbers in boldface refer to Figure 18.
Ventilation Mode Keys
1
4
2
Ventilation modes are selected by pressing one of
the ventilation mode keys (1, 2, 3) and are confirmed
by pressing the rotary knob. If the selection is not
confirmed, the ventilation mode will not change.
3
Standby Key
5
6
The Standby key (5) switches the ventilator to
standby mode.
Monitoring and alarms are turned off and the
ventilator stops.
Setup Key
The Setup key (4) is a cross-functional control. See
“Setup Key” on page 18.
Soft Keys
Soft keys (6) select ventilation parameters and
functions.
Ventilator Compliance Compensation
Ventilator compliance compensation is continuously
applied during Volume Control so that the tidal
volume delivered to the patient corresponds to the Vt
setting. Ventilator compliance is determined during
the leak and compliance test performed from the
Standby mode. To have compliance compensation
work accurately, it is important that the patient hoses
used during the leak/compliance test match the type
of hoses used during the procedure.
Note: When the ventilator settings for Volume
Control cause the ventilator to operate at its
limits of performance, it is not possible for
the Fabius GS to apply compliance
compensation. If the ventilator's performance
limit is reached, it is not possible to
increment the Vt setting via the Volume
Control Settings window.
24
Ventilation
Ventilation Screens
Soft Key Labels
Each soft key (1) is associated with a ventilation
parameter (2) that is associated with a specific
ventilation mode (3).
3
2
1
Volume Control Mode
The following soft key labels appear from left to right
along the bottom of the Volume Control screen.
See Figure 20.
•
PMAX (maximum ventilation pressure).
The range for PMAX is
15 to 70 cmH2O.
The factory default value is
40 cmH2O.
•
VT (tidal volume).
The range for VT is 20 mL to 1400 mL.
The factory default value is 600 mL.
•
Freq (ventilation frequency).
The range for Frequency is 4 bpm to 60 bpm.
The factory default value is 12 bpm.
•
TI:TE (time ratio between inspiration time and
expiration time phases).
The range for TI:TE is 4:1 to 1:4.
The factory default value is 1:2.
•
TIP:TI (relative inspiratory pause).
The range for TIP:TI is 0% to 50%.
The factory default value is 10%.
•
PEEP (positive end expiratory pressure).
The range for PEEP is
0 to 20 cmH2O.
0 cmH2O.
Figure 20. Volume Control Ventilation Screen
25
Pressure Control Mode
along the bottom of the Pressure Control screen.
See Figure 21.
•
PINSP (inspiratory pressure setting).
The range for PINSP is
5 to 60 cmH2O.
The factory default value is 15.
•
Freq (ventilation frequency).
The range for Frequency is 4 bpm to 60 bpm.
The factory default value is 12 bpm.
•
TI:TE (time ratio between inspiration and
expiration phases).
The range for TI:TE is 4:1 to 1:4.
The factory default value is 1:2.
•
Insp Flow (rate at which the piston travels
upward to create the target pressure).
The range for Insp Flow is
10 L/min to 75 L/min.
The factory default value is 30 L/min.
•
PEEP (positive end expiratory pressure).
The range for Peep is
0 to 20 cmH2O.
0 cmH2O.
ManSpont Mode
The “Apnea Pressure” and “Volume Alarms” labels
appear to the left of their ON/OFF label on the bottom
of the ManSpont screen. See Figure 22. Pressing the
ON/OFF soft key turns the applicable alarm(s) “ON”
or “OFF.”
Ventilation
Figure 21. Pressure Control Ventilation Screen
Figure 22. ManSpont Ventilation Screen
26
Ventilation
Standby Mode
along the bottom of the Standby screen.
See Figure 23.
•
Run System Test
•
Calibrate Flow Sensor
•
Calibrate O2 Sensor
•
Leak / Compl Test
•
Access Alarm Log
•
Restore Site Defaults
See “Standby Screen” on page 91 for details.
Flow Meter Monitor Window
Figure 24. Flow Meter Monitor Window
The Flow Meter Monitor window is a graphical
display of the flow rates of O2, Air, and N2O (L/min)
(1 in Figure 24).
Note: On some non-U.S. units of the Fabius GS,
1
the O2 and N2O virtual flow tubes have
changed positions.
27
Changing Ventilation Modes
Ventilation
Figure 25. Ventilator Mode Change Confirmation
1
Volume Control and Pressure Control
2
The following example describes changing
•
•
from the present ventilation mode “Volume”
(1 in Figure 25)
4
to the desired ventilation mode “Pressure”
(2 in Figure 25) with the desired ventilation
settings (3 in Figure 25).
1. Press the Pressure Control key.
The LED associated with this key starts blinking
(4 in Figure 25). It remains blinking until the
selected mode of operation is confirmed.
A message appears (5 in Figure 25) that
provides instructions to confirm the mode
change.
5
6
3
The Waveform window is replaced by the
Ventilator Settings window (6 in Figure 25)
(Volume and Pressure modes only).
2. If the ventilation settings are correct, confirm the
mode change.
3. If the ventilation settings are not correct, for each
parameter that needs to change, press the
corresponding soft key, select the correct value,
and confirm the change.
4. When the parameter changes are completed,
confirm the ventilation mode change.
28
After the mode change is confirmed, the
Pressure Control key LED switches from blinking
to constantly on, the ventilator switches to the
selected operating mode, and the waveform is
restored after a short delay.
Ventilation
Ventilator Setting Selection
Figure 26. Ventilator Mode Change Settings
The ventilator settings for the new mode of operation
are automatically derived from the settings and
performance of the last confirmed automatic
ventilation mode. Settings affected in the new mode
will be highlighted (1 in Figure 26).
The settings for Freq., TI : TE, and PEEP are taken
directly from the settings used in the former mode.
When changing from Volume Control to Pressure
Control, Pinsp is set to the Plateau pressure
developed in Volume Control.
When changing from Volume Control to Pressure
Control, the suggested value for Insp. Flow is either
the last used value or the site default value.
1
When changing from Pressure Control to Volume
Control, VT is set by dividing the last minute volume
by the respiratory rate.
Control, the suggested value for TIP : TI is either the
last used value or the site default value.
Control, PMAX is set 10 cmH2O higher than the
plateau pressure developed during Pressure Control.
29
ManSpont
Ventilation
Figure 27. Ventilator Mode Change to Man Spont
ManSpont (Manual/Spontaneous) is a non-automatic
mode of ventilation. However, the ventilation monitor
and alarms are still operational. In ManSpont mode,
the ventilator piston is moved to its top-most position
to minimize system compliance. Manual ventilation
(with APL valve pressure limit) can be delivered with
the APL valve switch in the MAN position.
Spontaneous ventilation (APL valve wide-open) can
occur with the APL valve in the SPONT position.
1
•
from the present ventilation mode “Volume”
(1 in Figure 27)
•
to the desired ventilation mode “ManSpont”
(1 in Figure 28).
Spontaneous Breathing
1. Press the ManSpont key.
4
3
The following examples describe changing
2
ManSpont window (3 in Figure 27).
change.
2. Confirm the mode change. The ManSpont
screen is activated (Figure 28).
ManSpont key LED switches from blinking to
constantly on and the waveform is restored after
a short delay.
4. Set the appropriate fresh gas flow.
3. Set the toggle on the APL valve (1 in Figure 29)
to the SPONT position.
Figure 29. APL Vavle
1
Note: The ManSpont screen enables you to
turn the Apnea Pressure alarm and
Volume alarms ON or OFF.
30
Ventilation
Manual Ventilation
Note: In ManSpont mode, the apnea volume timer
countdown for caution alarms changes from
15 seconds to 30 seconds, and for warning
alarms from 30 seconds to 60 seconds.
Figure 30. Ventilator Mode Change to Man Spont
1. Press the ManSpont key.
change.
2. Confirm the mode change. The ManSpont
screen is activated (Figure 31).
3
2
ManSpont window (2 in Figure 30).
1
ManSpont key LED switches from blinking to
constantly on and the waveform is restored after
a short delay.
Note: The ManSpont screen enables you to
turn the Apnea Pressure alarm and
Volume alarms ON or OFF.
3. Set the toggle on the APL valve (1 in Figure 32)
to the MAN position.
4. Adjust the pressure limiting valve to set the
appropriate value for the maximum ventilation
pressure.
5. Press the O2 flush button, as required, to inflate
the bag.
6. Set the fresh gas flow.
1
7. Start manual ventilation.
31
Selecting/Setting Ventilation Parameters
Ventilation
Figure 33. Volume Ventilator Settings Window
1. In Volume Control mode, press the Volume
Control key. The Volume Control Ventilation
Settings window (1 in Figure 33) replaces the
Waveform window.
In Pressure Control mode, press the Pressure
Control key. The Pressure Control Ventilation
Settings Window (1 in Figure 34) replaces the
Waveform window.
1
The following example continues in Volume Control
mode.
Figure 34. Pressure Control Ventilator Settings Window
2. Press the VT (tidal volume) soft key.
The Ventilator Settings window appears with the
VT parameter label highlighted (1 in Figure 35).
3. Select a new VT parameter setting.
4. Confirm the new VT parameter setting.
1
Note: Once the Ventilator Settings window is
Figure 35. Volume Control Ventilator Label Selected
activated, it will return to the Waveform
window if 15 seconds pass and neither the
rotary knob nor a soft key is pressed.
If the Home key is pressed, the Ventilator
Settings window will return to the Waveform
window.
In either case, the ventilation parameter will
remain as it was before it was activated in
the Ventilator Settings window.
1
32
Fresh Gas Control
Fresh Gas Control
The following numbers in boldface refer to Figure 36. Flow is increased when the flow control knobs (N2O (1),
AIR (2), O2 (3)) are turned counterclockwise.
The total flow meter (4) displays the flow measurement of all of the applied gases combined.
Note: The total flow meter is calibrated for a 50/50 mixture of N2O and O2. The accuracy of the flow meter may
degrade with other gas mixtures. (See the Technical Data section for specifications.)
The total flow meter serves two purposes. The total flow meter provides a reference of the total fresh gas applied
to the breathing circuit. (Flow rate measurements for each individual gas; N2O, Air, and O2; are provided by their
respective electronic flow indicator.)
Should a fault develop in the electronic flow sensing, digital display, or power circuitry, the total flow meter is still
functional. The measurement will indicate the total flow rate prior to the fault condition.
To adjust the fresh gas ratios while under the fault condition, shut off all flows (O2 may be left on), and then restore
each gas flow individually. For example, start with 2 L/min O2. The total flow meter will read 2 L/min.
If 1 L/min of N2O is needed, open the N2O flow control knob until the total flow meter reads 3 L/min - 2 L/min O2
plus 1 L/min N2O.
The electronic fresh gas flow indicators (N2O (5), AIR (6), O2 (7)) display the flow measurement of each gas.
Note: The electronic fresh gas flow meters are altitude corrected.
The central supply pressure indicators (N2O (8), AIR (9), O2 (10)) display the pressure measurement of each
gas entering the Fabius GS from the facility’s pipeline.
The cylinder gauges (O2 (11), Air (12)) display the pressure measurement of each gas entering the Fabius GS
from cylinders.
The O2 Low Supply Pressure Alarm LED (13) flashes when the O2 supply is below the factory set minimum
pressure, nominally 20 psi (1.4 bar).
Figure 36. Flowmeter and Pressure Gauge Assembly
4
1
5
Pipeline
L/min
6
2
Pipeline
AIR
L/min
TOTAL
FLOW
±15% FS
8
N2 O
3
7
Pipeline
O2
L/min
9
10
11
12
Cylinder
Pressure
13
O2
Air
33
Fresh Gas Flow Monitoring
Resolutions
Fresh Gas Flow Monitoring Resolutions
Figure 37. Standard Resolution Fresh Gas Flow Monitoring
The Fabius GS can be configured by your Local
Authorized Service Organization to display fresh gas
flow rates either in a standard resolution mode or in a
high resolution mode.
Standard Resolution
If standard resolution is configured (Figure 37), the
numeric displays (LEDs) for the fresh gas flow rates
support 100 ml/min. increments (format xx.x l/min.)
and the flow meters on the monitor screen indicate a
range of 0 to 12 l/min.
High Resolution
Figure 38. High Resolution Fresh Gas Flow Monitoring
If high resolution is configured (Figure 38), the
numeric displays (LEDs) for the fresh gas flow rates
support 10 ml/min. increments (format x.xx l/min.)
and the flow meters on the monitor screen indicate a
range of 0 to 10 l/min. with an emphasis on
resolution at the lower end of the scale.
High-resolution data is displayed when all individual
gas flows are below 9.99 l/min.
Switching to standard resolution occurs when the
highest flow rate is greater than 9.99 l/min.
Switching to high resolution occurs when the highest
flow rate drops below 9.00 l/min.
34
APL Valve
APL Valve
The APL valve (1) has two functions. It limits the
maximum pressure during manual ventilation. It also
exhausts excess gas into the scavenger system
during manual and spontaneous ventilation.
2
The APL valve is connected to the patient airway
through the ventilator. It functions only when the
ventilator is in ManSpont mode or ventilator override
condition.
The APL valve has a toggle switch (2) for selecting
between manual and spontaneous modes of
ventilation.
When the side of the switch marked MAN is up, the
APL valve sets maximum pressure for manual
ventilation. When the side marked SPONT is up,
pressure is released for spontaneous ventilation.
Depressing the switch while in the MAN position will
also temporarily relieve pressure.
3
1
Maximum pressure adjustment is made by rotating
the APL valve adjustment (3) when the toggle switch
is in the MAN position to set peak airway pressure.
The adjustment housing is labelled to indicate
pressure settings. Rotating the adjustment
counterclockwise reduces the peak inspiratory
pressure and the pressure at which gas is released
to the scavenging system. Rotating the adjustment
clockwise increases the peak inspiratory pressure
and the pressure at which gas is released to the
scavenging system.
During spontaneous ventilation, resistance to patient
exhalation is automatically eliminated by toggling to
the SPONT position, which eliminates the need to readjust backpressure.
35
Chapter 4 - Preparation
Contents
Preparation
Contents
Activating the Battery .............................................................................................. 39
Gas Supply .............................................................................................................. 39
Medical Gas Pipeline Supply of O2, N2O, and AIR ................................................ 39
Cylinders with Pin-index Mounting .......................................................................... 40
Electrical Supply ...................................................................................................... 41
Attaching Manual (Ambu) Ventilation Bag ............................................................... 41
Preparing the Ventilator ........................................................................................... 42
Ventilator Safety Features ....................................................................................... 42
Attaching the CO2 Absorber onto the Compact Breathing System ......................... 43
Attaching the Inspiratory Valve ................................................................................ 43
Attaching the Expiratory Valve ................................................................................. 43
Attaching the Adjustable Pressure Limiting (APL) Valve ......................................... 44
Inserting the Flow Sensor ........................................................................................ 44
Attaching the Waste Gas Outlet Port ....................................................................... 44
Connecting the Compact Breathing System ............................................................ 45
Connecting the Breathing Hoses ............................................................................. 46
Inserting A New O2 Sensor Capsule ....................................................................... 46
Connecting the O2 Sensor ...................................................................................... 47
Connecting the Pressure Sensor ............................................................................ 47
Connecting the Breathing Pressure Gauge ............................................................. 48
Connecting the APL Bypass and Peep/PMAX Hoses ............................................. 48
Connecting the Flow Sensor ................................................................................... 49
Installing Anesthetic Gas Scavenging Hose to the Compact Breathing System ..... 49
Scavenger System for Fabius GS ........................................................................... 50
Daily and Preuse Checkout Form ........................................................................... 50
37
Activating the Battery
Note: Complete the Periodic Manufacturer's
Service procedure (SP00225) after you set
up the Fabius GS anaesthesia machine.
Activating the Battery
Figure 40. Battery Fuse
The Fabius GS anesthesia machine is shipped with
the battery fuse disconnected in order to prevent
discharge during shipment and storage prior to
installation.
1. Remove the battery fuse from the top drawer of
the Fabius GS.
OXYGEN
SENSOR
BREATHING
PRESSURE
VOLUME
SENSOR
2. Remove the battery fuse from its packaging.
3. Insert the battery fuse into the battery fuse holder
(1 in Figure 40) (turn the fuse 1/4-turn clockwise
until it is snug).
Gas Supply
1
Figure 41. 3-Gas Supply Connections
Note: Medical gases must be dry and free from
dust and oil.
The central gas supply gas connections are shown in
Figure 41.
PIPELINE
Medical Gas Pipeline Supply of O2,
N2O, and AIR
Warning: Carefully check hoses each time you
PIPELINE
4
PIPELINE
1
2
3
connect a machine to a wall or ceiling
outlet to ensure that both ends of the
hose are indexed for the same gas.
Pipeline delivery hoses used between
wall outlets and anesthesia machines
have caused accidents when, during
assembly, an oxygen fitting was placed
on one end of the hose and a nitrous
oxide fitting on the other end.
1. Connect the N2O hose (1) to the connector on
the Fabius GS and to the wall terminal unit (4) of
the medical gas pipeline system.
2. Connect the AIR hose (2) to the connector on the
Fabius GS and to the wall terminal unit (4) of the
medical gas pipeline system.
3. Connect the O2 hose (3) to the connector on the
Fabius GS and to the wall terminal unit (4) of the
medical gas pipeline system.
39
Cylinders with Pin-index Mounting
Cylinders with Pin-index Mounting
Warning: When attaching a cylinder, ensure that
only one washer is installed between the
cylinder and the yoke gas inlet. The use
of multiple washers will inhibit the pinindex safety system. Be sure to verify the
presence of the index pins each time a
cylinder is installed. Never attempt to
override the pin-index safety system.
Caution: Do not oil or grease the O2 cylinder
valves and O2 pressure regulator. There
is a risk of explosion.
If cylinder valves are leaky or difficult to
open or close, they must be repaired in
accordance with the manufacturer’s
specifications.
Even if the gas supply is connected to a
medical gas pipeline, the cylinders
should remain on the device in reserve.
To connect a gas cylinder (1) to its yoke:
1. Remove the old washer (2) and install a new
washer on the seat of the yoke gas inlet
connection.
Figure 42. Pin Index Cylinder Mounting
7
10
8
2
5
9
1
5. Turn the yoke handle (7) clockwise against the
cylinder head, so that the point of the yoke
handle bolt is aligned with the indent on the back
of the cylinder head.
6. Verify that the washer is in place, the index pins
are engaged, and the cylinder hangs vertically.
7. Tighten the yoke firmly.
When required, the cylinder valve (8) is opened
using the cylinder wrench (9) that is provided.
8. When a cylinder is removed, place the
yoke plug (10) in the yoke assembly and tighten.
40
4. Engage the indexing holes with the index pins.
3
4
2. Verify that the two index pins (3) below the gas
inlet (4) are present.
3. Insert the head (5) of the gas cylinder into the
yoke from below. Ensure that the gas outlet and
indexing holes on the cylinder head align with the
gas inlet and index pins of the
yoke assembly (6).
6
Electrical Supply
Cylinders attached to the hanger yokes must contain
gas at the recommended pressures outlined in
Table 1. (Indicated pressures are of E-size cylinders
at 70° F, or 21° C.) Cylinders measuring less than the
minimum recommended pressure (PSI - MIN) should
be replaced with new, full cylinders.
Electrical Supply
Table 1. Recommended Cylinder Gas Pressures
GAS
PSI/bar - FULL
(typical full load)
PSI/bar - MIN
Air
1900/131
1000/69
Nitrous Oxide
745/51
600/42
Oxygen
1900/131
1000/69
Figure 43. Power Switch
Fabius GS can be operated at mains voltages from
100 V to 240 V.
Push power plug into supply mains socket.
Switch on the machine. The system power switch
(1 in Figure 43) is on the rear of the machine.
OXYGEN
SENSOR
BREATHING
PRESSURE
VOLUME
SENSOR
1
Attaching Manual (Ambu)
Ventilation Bag
Figure 44. Manual (Ambu) Ventilation Bag
Hang the fully prepared and tested bag on the rail at
the right (1).
1
41
Preparing the Ventilator
Preparing the Ventilator
Figure 45. Ventilator Assembly
Use only disinfected/sterilized components.
1. Swing out the ventilator door (1).
A B
6
3
2. Unlatch the three clasps (2) to remove the
cover (3).
5
3. Insert the diaphragm (4).
4. Fit the cover (3) and lock the three clasps.
2
5. Connect the ventilator chamber pressure sensor
line (5) to the ventilator chamber pressure sensor
line port (6).
4
6. Swing the ventilator unit (1) back into position.
1
Ventilator Safety Features
•
•
•
High pressure safety relief valve (A)
Negative pressure safety relief valve (B)
Ventilator chamber pressure sensor
Caution: Fabius GS anesthesia machines that
42
were shipped with a SW version 1.1x or
1.20 have a 3-cmH2O negative pressure
relief valve in the ventilator cover. These
ventilator covers must not be used with
machines equipped with software
version 1.30 or higher. Machines with
software version 1.30 or higher require a
ventilator cover with an 8-cmH2O
negative pressure relief valve. These
ventilator covers have a smaller locating
pin. The two covers are not
interchangeable. Using an incorrect
ventilator cover on a Fabius GS could
cause a ventilator malfunction. (All units
with SW version 1.1x or 1.20 can be
upgraded to SW version 1.30.)
Attaching the CO2 Absorber onto the Compact Breathing SystemChapter 4 - Preparation
Attaching the CO2 Absorber onto
the Compact Breathing System
Figure 46. CO2 Absorber
1. Remove the absorber canister (see “Replacing
CO2 Absorbent” on page 56 for more
information).
2. Fill the absorber with fresh CO2 absorbent to the
fill line.
Dräger Medical, Inc. recommends the use of
Drägersorb 800 Plus.
3. Ensure that no CO2 absorbent dust/particles
have been deposited between the gaskets and
the sealing surfaces. Such dust and particles can
cause leaks in the system.
4. Tighten the absorber by turning it to the right into
the compact breathing system.
Attaching the Inspiratory Valve
Figure 47. Inspiratory/Expiratory Valves
1. Place the valve disc (3) in the valve seat.
2. Place the gasket (4) on top of the valve disc.
3. Fit the inspection cap (with port) (5).
8
7
10
6
9
5
3
4
4. Tighten the retaining nut (6) securely.
Attaching the Expiratory Valve
1. Place the valve disc (7) in the valve seat.
2. Place the gasket (8) on top of the valve disc.
3. Fit the inspection cap (9).
4. Tighten the retaining nut (10) securely.
43
Attaching the Adjustable Pressure Limiting (APL) Valve
Attaching the Adjustable Pressure
Limiting (APL) Valve
Figure 48. APL Valve
Tighten the pressure-limiting valve (9 in Figure 48)
securely into place with the retaining nut.
9
Inserting the Flow Sensor
Figure 49. Flow Sensor Assembly
1. Unscrew and remove the expiration port (1).
2. Insert the flow sensor (2).
3. Reinstall the expiration port (1).
1
Attaching the Waste Gas Outlet
Port
3
2
Screw the waste gas port into the compact
breathing system from underneath
(3 in Figure 49).
44
Connecting the Compact Breathing System
Connecting the Compact Breathing
System
Figure 50. Compact Breathing System Installation
The following numbers in boldface refer to Figure 50
and Figure 51.
1
Caution: The sealing rings on the threaded and
conical connectors (5 and 6) must be
undamaged and clean.
Caution: Only hand-tighten the threaded
connectors. Do not use tools.
2
1. Pull and hold plunger (1) out to its full extension
on the compact breathing system.
2. Fit the compact breathing system onto the
compact breathing system mount (2).
3. Release the plunger (1) and rotate the compact
breathing system until the plunger locks into
position.
Figure 51. Hose Connections for Compact Breathing
System
4. Screw the fresh gas hose from the Fabius GS (3)
to the compact breathing system (4).
5
5. Screw the ventilation hose to the ventilator (5)
and attach it to the conical connector ventilator
port on the compact breathing system (6).
4
6
3
45
Connecting the Breathing Hoses
Connecting the Breathing Hoses
Figure 52. Breathing Hose Handling Caution
Note: Take care not to damage the breathing
hoses.
When connecting and disconnecting, always
hold the breathing hoses by the end sleeve,
not by the spiral reinforcement (Figure 52).
Otherwise, the spiral reinforcement may be
torn loose.
Breathing hoses with a damaged spiral
reinforcement can kink or become occluded.
Before each use, check the breathing hoses
for damage.
1. Push patient breathing hoses (1) onto both the
inspiratory and expiratory connectors or onto the
microbial filters.
Figure 53. Installing Breathing Hoses
2. Connect both patient breathing hoses to the
Y-piece (2).
3. Connect the bag (3) to the elbow port on the
compact breathing system.
1
3
Figure 54. O2 Sensor Capsule Assembly
Inserting a new O2 sensor capsule:
1. Unscrew the cap (1) from the sensor housing.
2. Remove the new sensor capsule from its
packaging, or use a disinfected sensor capsule.
3. Insert the capsule (2) in the housing, with the
ring-shaped conductors against the contacts in
the housing.
2
4. Screw the cap (1) on firmly by hand.
1
46
Inserting A New O2 Sensor Capsule
2
Connecting the O2 Sensor
Connecting the O2 Sensor
Figure 55. Connecting the O2 Sensor Capsule
Push the O2 sensor into the port opening of the
inspiratory port dome (1), and plug the connector into
the connector panel.
OXYGEN
SENSOR
BREATHING
PRESSURE
VOLUME
SENSOR
2
1
OP00336A
Connecting the Pressure Sensor
Figure 56. Pressure Sensor Connections
Press the pressure measuring line hose onto the
hose barb (1) until it engages.
Caution: Do not squeeze the pressure measuring
line hose when pressing it onto the hose
barb.
OXYGEN
SENSOR
BREATHING
PRESSURE
VOLUME
SENSOR
Connect the pressure measuring line hose to the
bacterial filter (2) and plug it firmly onto the port on
the connector panel.
2
1
47
Connecting the Breathing Pressure
Gauge
Connecting the Breathing Pressure Gauge
Figure 57. Breathing Pressure Gauge
1. Connect the pressure gauge (1) to the compact
breathing system mount (2) and secure with the
retaining screw (3) and lockwasher (4).
7
Push the pressure measuring line hose onto the
hose barb (5), the breathing pressure gauge port (6),
and onto the port on the connector panel (7).
1
6
5
4
2
3
Connecting the APL Bypass and
Peep/PMAX Hoses
Figure 58. APL Bypass and Peep Hose Connections
1. Plug the control hose to the connection port on
the PEEP/PMAX valve (1) and to the connection
port marked “PEEP” on the connection panel (2).
Note: The control hoses are connected together
4
VOLUME
SENSOR
2
1
3
near the end of each hose. The APL bypass
hose is larger than the PEEP/PMAX hose.
48
2. Plug the control hose to the connection port on
the APL Bypass valve (3) and to the connection
port marked “APL” on the connection panel (4).
OXYGEN
SENSOR
BREATHING
PRESSURE
Connecting the Flow Sensor
Connecting the Flow Sensor
Figure 59. Connecting the Flow Sensor
Push the cable onto the connection port on the flow
sensor (1).
OX YG EN
SEN SO R
B REA THI NG
P RES SUR E
VO LUM E
SEN SO R
1
OP00337A
Installing Anesthetic Gas
Scavenging Hose to the Compact
Breathing System
Figure 60. Installing the Scavenger Transfer Hose
Connect the transfer hose to the waste gas port of
the Compact Breathing System and to the anesthetic
gas scavenging line or an anesthetic agent filter.
A second transfer hose is required for the Semi-open
compact breathing system.
49
Scavenger System for Fabius GS
Scavenger System for Fabius GS
Figure 61. AGS Scavenger
Caution: Do not use anesthetic gas scavenging
AGS
system in combination with
extracorporeal oxygenator.
4
Output connection (1) from the scavenger system to
the hospital waste gas removal system.
Connection to scavenger system (2) from Fabius GS
breathing system.
1
2
3
Flow indicator (3). During use, the flow indicator must
be between the upper and lower marks on the tube.
Flow adjustment valve (4).
Note: Activate hospital vacuum system before
using scavenger system.
For more detailed information on the scavenger
system, refer to the separate specific Instructions for
Use.
For detailed information regarding mounting the
scavenger system to the Fabius GS anesthesia
workstation, refer to specific instructions provided
with the scavenger kit.
Additional Equipment
Prepare additional equipment as specified in the
specific Instructions for Use.
Caution: If monitors and other equipment are
placed on top of Fabius GS, the risk of
tipping over the unit is increased,
especially when rolling over thresholds
etc.
Remove all monitors and other equipment from the
top of the Fabius GS before moving the unit.
Daily and Preuse Checkout Form
Complete the “Daily and Preuse Checkout Form” in
Appendix A.
50
Chapter 5 - Operation and Shut-down
Contents
Operation and Shut-down
Contents
Operation ................................................................................................................. 53
Power-Up Screen ................................................................................................. 53
Power-Up Standby Screen ................................................................................... 54
Ventilation Monitor Screen .................................................................................... 54
Setting the Vapor .................................................................................................. 54
O2 Flush ............................................................................................................... 55
Minimum Flow of Anesthesia ................................................................................ 55
Nitrogen Wash-out (When Required) ................................................................... 55
Replacing CO2 Absorbent .................................................................................... 56
Power Failure Backup .......................................................................................... 57
Ventilator Fail State ............................................................................................... 58
Overriding the Ventilator ....................................................................................... 59
Preparation for Transport or Storage ....................................................................... 60
Switch Off the Anesthetic Agent Vaporizer ........................................................... 60
Switching Off the Ventilator .................................................................................. 61
Remove the O2 Sensor ........................................................................................ 61
Switch Off System Power ..................................................................................... 61
Disconnect the Central Gas Supply ...................................................................... 62
51
Operation
Operation
Power-Up Screen
Figure 62. Power-Up Screen
When the SYSTEM POWER switch is turned to the
ON position, the Fabius GS performs extensive selftests on its internal hardware. As these diagnostics
are performed, each test and its result appear on the
screen. The result, Pass or Fail, indicates the status
of the tested component. See Figure 62.
Self-Diagnostic Conclusions
At the end of the self-diagnostics, one of three
possible conclusions to the self-tests is posted on the
screen (Figure 62).
FUNCTIONAL
Every component of the monitoring system is in
satisfactory operational order. After a brief delay, the
Standby screen appears.
CONDITIONALLY FUNCTIONAL
A noncritical fault was detected. The Fabius GS may
be used, but call your local Authorized Service
Organization or DrägerService (see “Daily and
Preuse Checkout Form” for DrägerService contact
information).
Press the rotary knob to continue operation.
NON-FUNCTIONAL
A serious fault was detected and operation of the
monitor and ventilator is inhibited. Do not use the
machine. Immediately call your local Authorized
Service Organization or DrägerService to correct the
problem.
53
Power-Up Standby Screen
Operation
Figure 63. Power-Up Standby Screen
Following a successful power-up, the Standby screen
appears (Figure 63) and provides instructions on
starting the operation of the Fabius GS.
Ventilation Monitor Screen
When the Fabius GS is in use, monitoring
information is displayed on the Ventilation Monitor
screen.
See “Operating Concept” on page 15 for an
explanation of the Ventilation Monitor screen controls
and windows.
Setting the Vapor
Figure 65. Setting the Vapor
1. Ensure that the vaporizer is properly seated.
2. Lock the unused Vapor by sliding the lever (1) as
far as it will go in the direction of the unused
Vapor (in this example, the left hand Vapor is
locked).
3. On the Vapor to be used, press and hold down
the 0 button (2) and turn the handwheel (3)
counter-clockwise to the desired anesthetic
agent concentration.
1
3
2
4. Regularly check the filling level on the sight
glass. When reaching the minimum mark, fill the
Vapor with anesthetic agent.
5. Please refer to the specific Instructions for Use
for Dräger Vapor.
54
Operation
O2 Flush
1. Press the O2 Flush button (1 in Figure 66).
Additional O2 flows into the compact breathing
system. The flow control elements and the
anesthetic agent vaporizer (Vapor) are
bypassed.
Figure 66. O2 Flush Button
1
Note: In Man. Spont. mode, pressure may rise
rapidly up to the setting of the APL valve.
Minimum Flow of Anesthesia
When long-term flow of anesthesia is below
0.5 L/min, increased humidity in the ventilator hose is
a natural occurrence. Disconnect the ventilator hose
from the compact breathing system and clean before
and after long term procedures. Use water traps in
the expiratory hose. Empty water traps if their water
level exceeds the maximum water level limit.
Nitrogen Wash-out (When Required)
During anesthesia induction, air containing about
79% nitrogen (N2) remains in the compact breathing
system (and in the patient's lungs). If the unit will be
used for a low-flow anesthesia case, press the O2
Flush to remove this N2.
55
Replacing CO2 Absorbent
Operation
Figure 67. Replacing the Absorber Canister
The CO2 absorbent in the compact breathing system
should be replaced when two-thirds of the CO2
absorbent has changed color. Draeger Medical
recommends the use of Drägersorb 800 Plus. The
color change indicates that the CO2 absorbent can
no longer absorb CO2 (Drägersorb 800 Plus changes
from white to violet).
Do not flush CO2 absorbent for long periods with dry
gas because the CO2 absorbent will dry out.
When the moisture content falls below a specified
minimum level, the following undesirable reactions
can occur, regardless of the type of CO2 absorbent
and the anesthetic agent used, e.g. Halothane,
Enflurane, Isoflurane, Sevoflurane or Desflurane:
•
•
•
•
reduced CO2 absorption,
formation of CO,
absorption and/or decomposition of the
inhalation anesthetic agent,
increased heat generation in the absorber,
leading to higher breathing gas temperatures.
These reactions can result in danger to the patient in
the form of CO intoxication, insufficient depth of
anesthesia and airway burns.
Note: Please refer to the specific Instructions for
Use for “Drägersorb 800 Plus”.
Draeger Medical recommends that absorbent be
changed, regardless of color, if the anesthesia
machine has been idle for 48 hours or more. Further,
Draeger Medical recommends that it be changed at
the beginning of the work week.
Warning: Absorbent is caustic and is a strong
irritant to the eyes, skin, and respiratory
tract. When replacing the absorbent,
take care not to spill its caustic contents.
1. Empty the expired CO2 absorbent from the
absorber into an appropriate refuse container.
2. Fill the absorber with fresh CO2 absorbent.
sealing surfaces. Such dust and particles can
Dräger recommends the use of Drägersorb 800 Plus.
56
Operation
Power Failure Backup
In case of power failure:
•
•
•
•
•
•
the machine will continue without interruption,
the “POWER FAIL” caution message will be
displayed in the Alarm window,
the battery symbol (r) will appear in the
status bar,
and the Mains Power Applied LED turns off.
At 20% of reserve power, the Advisory
message “BATTERY LOW!” is displayed in the
alarm window.
At 10% of reserve power, the Caution message
“BATTERY LOW!!” is displayed in the alarm
window.
Warning: When the Caution message “BATTERY
LOW!! is displayed in the alarm window,
less than nine minutes remain until the
electronics shut down. The electronics
will remain shut down until AC is
restored.
Caution: Never allow the battery to completely
discharge. If the battery does discharge
completely, recharge immediately.
If the power failure extends beyond the life of the
battery or in the event of a power supply failure, the
pneumatic functions (APL valve, breathing pressure
gauge, S-ORC, cylinder and pipeline gauges, total
flow meter, vaporizers, and fresh gas flow control) of
the Fabius GS remain functional. Manual or
spontaneous ventilation can be maintained.
57
Operation
Ventilator Fail State
If the Fabius GS does not recover from a
VENTILATOR FAIL condition,
1. Switch to ManSpont mode by pressing the
ManSpont key and confirming the mode change
by pressing the rotary knob.
2. Set the APL valve to MAN position.
3. Adjust the APL pressure limit for the desired
inspiratory plateau pressure.
4. Press the O2 flush button on the Fabius GS as
required to sufficiently inflate the breathing bag.
5. Manually ventilate the patient by squeezing the
breathing bag.
Note: In the ventilator fail situation, the
ventilator piston assembly position may
not be locked. As a result, airway
pressure may initially push the piston
back to its limit stop, increasing the
volume of the breathing bag. It may be
necessary to press the O2 flush button
again to reinflate the breathing bag.
58
Operation
Overriding the Ventilator
In the unlikely event of a fault in which the ventilator
does not recover, and the user cannot switch to
manual ventilation mode through the use of the
ManSpont key and rotary knob, manual ventilation is
still possible.
1. Locate the system power switch on the rear
panel.
2. Toggle the system power switch to “off” (Figure
68) and then
Figure 68. Toggle Power Switch to Off Label
3. Toggle the system power switch back to “on”
(Figure 69).
Figure 69. Toggle Power Switch to On Label
The ventilator now performs as in ManSpont
mode.
4. Set the APL valve to MAN position.
5. Adjust the APL pressure limit for the desired
inspiratory plateau pressure.
6. Press the O2 flush button on the Fabius GS as
required to sufficiently inflate the breathing bag.
7. Manually ventilate the patient by squeezing the
breathing bag.
Note: After toggling the main power switch, the
Fabius GS will perform its diagnostic
tests. During the diagnostic tests,
manual ventilation is possible. If the
diagnostic tests result in
“FUNCTIONAL”, the Fabius GS will
automatically switch to ManSpont mode
if fresh gas flow is detected. Fabius GS
respiratory monitoring is available. If the
diagnostic tests result in NONFUNCTIONAL, Manual ventilation is still
possible but Fabius GS respiratory
monitoring is not available.
Note: In ventilator override situation the
ventilator piston assembly position may
not be locked, as in ManSpont mode. As
a result, airway pressure may initially
push the piston back to its limit stop,
increasing the volume of the breathing
bag. It may be necessary to press the
O2 flush button again to reinflate the
breathing bag.
8. Contact your local Authorized Service
Organization before using the ventilator.
59
Preparation for Transport or Storage
Preparation for Transport or
Storage
Warning: When moving the anesthesia machine,
remove all monitors and equipment from
the top shelf, remove the absorber
system, and use only the machine
handles to push or pull the unit. The
anesthesia machine should only be
moved by people who are physically
capable of handling its weight. Draeger
Medical recommends that two people
move the anesthesia machine to aid in
maneuverability. Exercise special care
so that the machine does not tip when
moving up or down inclines, around
corners, and across thresholds (for
example, in door frames and elevators).
Do not attempt to pull the machine over
any hoses, cords, or other obstacles on
the floor.
Switch Off the Anesthetic Agent
Vaporizer
Figure 70. Closing the Vaporizer
(Dräger Vapor)
Turn the handwheel (1 in Figure 70) to 0 until the
button engages.
1
60
Switching Off the Ventilator
Figure 71. Turning off the Ventilator
1. Switch the anesthesia ventilator to standby by
pressing the Standby button (1).
2. Confirm by pressing the rotary knob (2). Fabius
GS is now in standby mode.
2
1
Remove the O2 Sensor
Remove the O2 sensor from the inspiratory valve and
leave exposed to air. This precaution prolongs the
service life of the O2 sensor.
Switch Off System Power
Figure 72. Control Unit On/Off Switch
Switch off the unit using the switch at the back (1)
and disconnect the power plug.
OXYGEN
SENSOR
BREATHING
PRESSURE
VOLUME
SENSOR
1
61
Disconnect the Central Gas Supply
Figure 73. Central Gas Supply
1. Remove all plug-in couplings from the wall
terminal units.
2. Close gas cylinders.
3. Press the O2 Flush to depressurize the entire
system.
PIPELINE
PIPELINE
PIPELINE
62
Chapter 6 - Monitoring
Contents
Monitoring
Contents
Overview ................................................................................................................. 65
Alarms ..................................................................................................................... 65
Alarm Limits Key ................................................................................................... 65
Alarm Tones .......................................................................................................... 65
Alarm Text Display Convention ............................................................................. 65
Oxygen Monitoring .................................................................................................. 66
Oxygen Monitoring Overview ............................................................................... 66
Oxygen Monitor Window ...................................................................................... 66
Oxygen Monitor Controls ...................................................................................... 67
Setting Oxygen Alarm Limits ................................................................................ 67
Calibrating the Oxygen Sensor ............................................................................. 68
Oxygen Alarm Messages ..................................................................................... 70
Oxygen Monitoring Problem Resolution ............................................................... 71
Respiratory Volume Monitoring ............................................................................... 72
Respiratory Volume Monitoring Overview ............................................................ 72
Respiratory Volume Monitor Display .................................................................... 73
Respiratory Volume Monitor Controls ................................................................... 74
Setting the Minute Volume Alarm Limits ............................................................... 74
Respiratory Volume Alarm Messages .................................................................. 75
Respiratory Volume Monitoring Problem Resolution ............................................ 76
Breathing Pressure Monitoring ................................................................................ 77
Breathing Pressure Monitoring Displays .............................................................. 77
Breathing Pressure Monitor Controls ................................................................... 78
Setting the Pressure and Threshold Alarm Limits ................................................ 78
Breathing Pressure Alarm Messages ................................................................... 79
Problem Resolution .............................................................................................. 81
63
Overview
Overview
This chapter describes functions that are specific to
oxygen monitoring, respiratory volume monitoring,
and breathing pressure monitoring. For information
on general monitoring functions, see “Operating
Concept” on page 15.
Alarms
Setting Alarm Limits
The Alarm Limits key enables you to set alarm limits
for the present procedure.
To set the default alarm limits that take effect at
power-up, see “Setting Alarm Limit Defaults” on
page 98.
Alarm Limits Key
The Alarm Limits key is shown at 1 in Figure 74.
1
2
Displays the Alarm Limits window (1 in Figure 75).
Use the select and confirm process outlined in
“Selecting/Setting Monitoring Functions” on page 22
to change the alarm limits on the Alarm Limits
window.
Alarm LED Indicators
The Alarm LED indicators are shown at 2 in
Figure 74. See “LED Indicators” on page 20 for
details.
Alarm Tones
Figure 75. Alarm Limit Configure Menu Window
The alarm tones provide an audible alert to the
message displays. Each message is assigned a tone
or sequence of tones to indicate its degree of
urgency.
•
Warning (continuous)
•
Caution (every 30 seconds)
•
Advisory (single signal or no tone for selected
advisories only)
1
Alarm Text Display Convention
•
•
•
Warnings are followed by three exclamation
marks (!!!).
Cautions are followed by two exclamation
marks (!!).
Advisories are followed by one exclamation
mark (!).
65
Oxygen Monitoring
Oxygen Monitoring
Oxygen Monitoring Overview
Inspiratory oxygen concentration is measured with a
dual galvanic cell sensor, which is attached to the
inspiratory valve dome. The sensor contains two
independent electrochemical cells, or sensor halves.
When the sensor is exposed to oxygen, an
electrochemical reaction occurs within each cell. The
oxygen monitor measures the current produced in
each cell, computes an average for the two cells, and
translates the average into an oxygen concentration
measurement.
Caution: Never remove an oxygen sensor from its
housing, except to replace it. If a sensor
is removed from its housing, you must
do the following before continuing
normal operations:
• Reinstall the sensor in the housing.
• Calibrate the sensor.
Note: When the machine is not in use, remove the
oxygen sensor assembly from the inspiratory
valve dome, and insert the valve dome plug
into the dome.
Oxygen Monitor Window
Figure 76.
•
66
1
2
3
•
•
1 - the numerical value for inspiratory oxygen
concentration in units of percent (%) between
10% and 100%
2 - the high oxygen concentration alarm limit
3 - the low oxygen concentration alarm limit
Figure 76. Oxygen Monitor Window
Oxygen Monitoring
Oxygen Monitor Controls
Figure 77. Monitor Controls
You use the Alarm Limits key (1), Setup key (2), and
rotary knob (3) to set oxygen concentration alarm
limits and calibrate the oxygen sensor.
1
2
3
Setting Oxygen Alarm Limits
At power-up, the oxygen high and low alarm limits
are automatically set to their default settings (See
“Default Settings” on page 95 for more information).
You can adjust these limits within specified ranges.
Oxygen Alarm Limits
Oxygen High Limit
The Oxygen High Alarm Limit range is from 19% to
100%. The Oxygen High Limit can not be set less
than or equal to the Oxygen Low Limit. The factory
default for Oxygen High Limit is 100%.
Oxygen Low Limit
The Oxygen Low Alarm Limit range is from 18% to
99%. The Oxygen Low Alarm Limit can not be set
equal to or greater than the Oxygen High Limit.
The factory default value for Oxygen Low Limit is
20%.
Procedure
See “Alarms” on page 65 to change the high or low
alarm limit.
67
Calibrating the Oxygen Sensor
Oxygen Monitoring
To calibrate the oxygen sensor correctly, make sure it
is exposed only to room air during the entire
calibration period. The oxygen sensor should be
calibrated as part of the daily preoperative setup of
the anesthesia equipment.
1
1. Press the Setup key (1 in Figure 78).
The Setup screen appears (Figure 79).
2. Press the soft key under the Calibrate O2 Sensor
soft key label (1 in Figure 79).
1
Figure 80. Calibrate O2 Sensor Instruction Screen
After the instructions are followed and the rotary
knob is pressed, the present O2 value is replaced by
“CAL” (1 in Figure 81).
Figure 81. Calibrate O2 Sensor in Progress Bar
1
Upon successful completion of the calibration, the O2
concentration measurement is restored.
If, at the end of the calibration period, the
O2 SENSOR FAIL! Advisory message appears in the
Alarm window, the calibration was not successful.
An unsuccessful calibration can be caused by
several conditions as described in Table 2 on
page 69.
68
The Calibrate O2 Sensor Instruction window
replaces the Setup screen soft key labels window
(Figure 80).
Oxygen Monitoring
Table 2. Unsuccessful Calibration - Causes and Solutions
Cause
Solution
Sensor was exposed to an excessively lean or
excessively rich oxygen calibration mixture.
Make sure that the sensor is exposed to room air for the entire
calibration period.
Sensor was exposed to a constantly changing
calibration mixture.
Make sure that the sensor is exposed to room air for the entire
calibration period.
Sensor did not receive the proper waiting period.
If the sensor capsule was removed from the sensor assembly, a waiting
period equal to the time that the capsule spent outside the sensor
assembly is necessary prior to calibration. New sensors require a 15minute waiting period.
Sensor is exhausted.
If the oxygen sensor has decayed beyond its useful service life (see the
“Specifications” section of the manual), replace the exhausted sensor
with a new sensor and allow the proper waiting period.
Sensor is disconnected.
When the sensor is disconnected or if there is no cell in the housing, the
display area is blank, and the message O2 SENSOR FAIL! appears in
the Alarm window. If this happens, ensure that the sensor is correctly
assembled and recalibrate the oxygen sensor.
Consequences
If the oxygen sensor is improperly calibrated, it can
cause inaccurate measurements. When a calibration
gas mixture is excessively rich or lean in oxygen, the
Fabius GS will not complete an attempted
calibration; however, if the calibration gas is rich or
lean but is within certain limits, the Fabius GS will
complete the calibration. As a result, when displaying
sensor measurements, the Fabius GS displays an
oxygen percentage either higher or lower than the
actual oxygen percentage. Therefore, make sure that
the sensor is exposed only to room air during the
entire calibration period.
Figure 82 illustrates the relationship between the
calibration mixture and the accuracy of oxygen
measurement.
A = Displayed O2 Percentage
B = Actual O2 Percentage
1 = At calibration, sensor exposed to < 21% O2.
Thus, displayed % O2 will be higher than actual
O2.
Figure 82. Measurement Error Due to Incorrect Calibration
100
90
80
1
70
A
60
50
40
2
30
20
3
10
0
10
20
30
40
50
60
70
80
90
100
B
2 = Correct calibration of room air (21% O2) for
entire calibration period. Displayed % O2 =
actual % O2.
3 = At calibration, sensor exposed to > 21% O2.
Thus, displayed % O2 will be lower than actual
% O2.
69
Oxygen Monitoring
Oxygen Alarm Messages
The following list contains all warning, caution, and
advisory alarms associated with oxygen monitoring.
INSP O2 LOW (Warning)
The Warning message INSP O2 LOW!!! appears in
the Alarm window and an alarm sounds if the
measured inspiratory oxygen concentration falls
below the low alarm limit.
O2 SUPPLY LOW (Warning)
The Warning message O2 SUPPLY LOW!!! appears
in the Alarm window and an alarm sounds if the
oxygen supply drops too low to properly pressurize
the fresh gas circuit (below about 20 psi (1.4 bar)).
The red LED indicator in the O2 area will flash until
the O2 supply is restored.
Under normal operating conditions, the O2 supply
channel is pressurized sufficiently to prevent this
alarm from occurring. If the O2 supply pressure fails
and O2 is not being used by the Fabius GS, the
circuit will remain pressurized and the O2 SUPPLY
LOW alarm will not annunciate immediately. If
pressure is reduced in this circuit by the use of O2,
O2 flush, etc., the alarm will annunciate when the
internal supply pressure drops below 20 psi (1.4 bar),
nominal.
INSP O2 HIGH (Caution)
If the measured inspiratory oxygen concentration
exceeds the high alarm limit, the Caution message
INSP O2 HIGH!! appears in the Alarm window, and
an intermittent audible alarm sounds.
O2 SENSOR FAIL (Advisory)
The Advisory message O2 SENSOR FAIL! appears
in the Alarm window when any of the following
instances occur:
•
•
•
•
•
O2 sensor has not been correctly calibrated.
O2 sensor replaced and/or not calibrated.
O2 sensor used up.
O2 sensor disconnected.
Faulty sensor cable.
O2 SENSOR CAL DUE (Advisory)
More than 18 hours have passed since the last
sensor calibration.
70
Oxygen Monitoring
Oxygen Monitoring Problem Resolution
Table 3. Oxygen Monitoring Problem Resolution
PROBLEM
POSSIBLE CAUSE
REMEDY
Alarm Message O2 SENSOR FAIL!
appears in Alarm window.
Sensor needs calibration
(Display area remains blank when a
reading is expected.)
Perform proper calibration. Remove
sensor assembly from breathing circuit.
Make sure sensor is exposed to room air
only. Calibrate the sensor.
Hardware malfunction.
Contact your local Authorized Service
Organization or DrägerService.
Faulty sensor housing and cable.
Replace housing/cable assembly.
Sensor cord is disconnected.
Insert sensor cord connector into the
interface panel.
Sensor is disconnected.
Insert sensor cord connector into the
interface panel.
Sensor cord is damaged.
Replace housing/cord assembly.
Sensor is exposed to incorrect oxygen
concentration.
Expose sensor to room air for 21%
calibration.
Pressing the Calibrate O2 Sensor
soft key does not initiate calibration.
Sensor exposed to constantly changing
calibration mixture.
Sensor capsule was removed from
housing for a prolonged period.
Allow a waiting period equal to duration
of capsule removal.
New capsule not given proper waiting
period.
Allow 15 minute waiting period.
Exhausted or faulty sensor capsule.
Replace sensor capsule.
Pressing Calibrate O2 Sensor soft
key initiates calibration, but Oxygen
Monitor window is blank at end of
calibration period.
71
Respiratory Volume Monitoring
Overview
Respiratory volume is measured using thermal
anemometry. The flow sensor output is converted
into meaningful readings for minute volume, tidal
volume, and respiratory rate displays.
Caution: Although the Fabius GS is designed to
minimize the effects of ambient radiofrequency interference, the functioning of
the respiratory volume monitor may be
adversely affected by the operation of
electrosurgical equipment or short wave
or microwave diathermy equipment in
the vicinity.
Note:
Sudden, irregular expiratory flow may
cause erratic tidal volume and
respiratory rate displays. To avoid such
erroneous measurements, defer reading
the display until a full minute has elapsed
after the irregular flow has stopped.
72
Respiratory Volume Monitor Display
Information about the patient's respiratory volume is
presented in the Respiratory Volume Monitor window
in the middle of the monitor display as shown in
Figure 83. From left to right, measured values are
shown for breathing frequency (1), tidal volume (2),
and minute volume (3). At the extreme right, in small
type, is the minute volume high alarm limit (4) and
the minute volume low alarm limit (5).
Figure 83. Monitor Display
4
1
2
3
5
Figure 83.
•
Frequency (Freq) (1)
Shows the number of breaths during the
previous minute of respiration.
Readings appear after two breaths.
The numeric data is displayed in units of
Breaths Per Minute (bpm).
The display range is from 2 bpm to 99 bpm.
•
Tidal Volume Measurement (VT) (2)
Displays the expired volume for each breath.
If the monitor does not detect a valid breath
within 30 seconds in an automatic ventilation
mode or within 60 seconds in ManSpont mode,
the display area goes blank.
milliliters (mL).
The display range is from 0 mL to 1500 mL.
•
Minute Volume Measurement (MV) (3)
Continuously displays the volume of exhaled
gas accumulated during the previous minute of
respiration.
liters/minute (L/min).
The display range is from
0.1 L/min to 99.0 L/min.
•
Minute Volume Alarm High Limit (4)
Indicates the volume above which an alarm
condition occurs.
•
Minute Volume Alarm Low Limit (5)
Indicates the volume below which an alarm
condition occurs.
73
Respiratory Volume Monitor Controls
Figure 84.
Figure 84. Respiratory Volume Monitor Controls
1
You can use the Alarm Limits key (1), the Standby
key (2), and the rotary knob (3) to set the high and
low respiratory volume alarm limits.
While the ventilator is on, apnea volume alarms are
generated at 15 seconds (Caution) and 30 seconds
(Warning) if the respiratory volume monitor does not
sense a valid breath. While the ventilator is off and
the system is in ManSpont mode, these alarms are
generated at 30 seconds (Caution) and 60 seconds
(Warning).
3
2
The Fabius GS's volume alarms are automatically
enabled when the ventilator is switched from Standby
to a ventilation mode.
Setting the Minute Volume Alarm Limits
If the minute volume falls below the minute volume
low alarm limit or above the minute volume high limit,
an alarm condition occurs.
Minute Volume High Limit
The Minute Volume High Limit range is from
0.1 L/min. to 20.0 L/min.
Factory default value: 12.0 L/min.
Minute Volume Low Limit
The Minute Volume Low Limit range is from
Factory default value: 3.0 L/min.
Procedure
See “Alarms” on page 65 to change the low alarm
limit.
74
Respiratory Volume Alarm Messages
The following list contains all warning, caution, and
advisory alarms associated with respiratory volume
monitoring.
APNEA VOLUME (Warning/Caution)
The Fabius GS continuously monitors the expiratory
flow in the patient breathing system. By processing
the expiratory flow pattern, the monitor can
determine whether a valid breath has occurred. A
valid breath has a tidal volume of 20 mL or greater.
When the ventilator is on:
•
If 15 seconds pass and a valid breath is not
detected, the Caution message APNEA
VOLUME!! appears in the Alarm window, and
• If an additional 15 seconds pass (30 seconds
total) and a valid breath is not detected, the
Caution message APNEA VOLUME!! is
upgraded to a Warning in the Alarm window,
and a continuously repeating audible alarm
sounds.
During apneic conditions, the respiratory volume
measurements disappear after 30 seconds. When a
valid breath is detected, alarm annunciation ceases
and a tidal volume measurement appears in the
display window.
When the system is in ManSpont Mode:
•
The Caution condition does not occur until 30
seconds have elapsed without a valid breath.
• The Warning condition does not occur until 60
seconds have elapsed without a valid breath.
During apneic conditions, the respiratory volume
measurements disappear after 60 seconds. When a
valid breath is detected, alarm annunciation ceases
and a tidal volume measurement appears in the
display window.
EXP PORT LEAKAGE (Caution)
Expiratory volume during inspiration is greater than
15 mL.
MINUTE VOLUME HIGH (Caution)
Whenever the Fabius GS measures a minute volume
higher than the high minute volume alarm limit, the
Caution message MINUTE VOLUME HIGH!!
appears in the Alarm window, and an intermittent
audible alarm sounds.
75
MINUTE VOLUME LOW (Caution)
Whenever the Fabius GS measures a minute volume
less than the low minute volume alarm limit, the
Caution message MINUTE VOLUME LOW!! appears
in the Alarm window, and an intermittent audible
alarm sounds.
FLOW SENSOR CAL DUE (Advisory)
The FLOW SENSOR CAL DUE! advisory message
appears in the Alarm window if it has been longer
than 18 hours since the flow sensor has been
calibrated.
FLOW SENSOR FAIL (Advisory)
The FLOW SENSOR FAIL! advisory message
appears in the Alarm window if the sensor cable is
not properly connected to the interface panel, if there
is an internal sensor fault.
VOLUME ALARMS OFF (Advisory)
Volume alarms disabled by the operator when in
ManSpont mode.
Respiratory Volume Monitoring Problem
Resolution
Table 4. Respiratory Volume Monitoring Problem Resolution
POSSIBLE CAUSE
REMEDY
Blank display area
Two breaths have not elapsed (for
minute volume and respiratory rate)
since respiration began.
Wait for two breaths to read display.
Apnea condition
Correct apnea condition. Ensure sensor
is properly connected to the expiratory
valve.
Sensor cable is disconnected.
Reconnect sensor cable to sensor at
breathing system.
Sensor fault
Replace sensor assembly.
Flow sensor signal drift
Calibrate the sensor.
Desflurane compensation setting not
consistent with actual agent delivered
Activate or deactivate “Des Comp” as
appropriate.
External agent analyzer providing
inaccurate data through the
communications port.
Check agent analyzer. Check
communications cable. Disconnect
analyzer from the Fabius GS and set
“Des Comp” appropriately.
Blank display area, FLOW SENSOR
FAIL! alarm message in Alarm
window
Inaccurate data displayed
76
PROBLEM
Breathing Pressure Monitoring
Figure 85. Breathing Pressure Monitoring Displays
Breathing Pressure Monitoring Displays
Information about the patient's breathing pressure is
presented in the Breathing Pressure Monitor Window
(1 in Figure 85) and in the Breathing Pressure Trace
Window (2 in Figure 85).
The Breathing Pressure Monitor window contains
breathing pressure measurements expressed in units
of cmH2O as well as the pressure high and pressure
threshold alarm limits. The measurement units are
selected via the Configuration screen (see
“Configuration” on page 101).
1
2
Note: The Fabius GS can be configured by your
Local Authorized Service Organization to
display mean pressure (MEAN) instead of
plateau pressure (PLAT).
Figure 86.
•
1 - PEEP (Positive End Expiratory Pressure)
The breathing pressure at the end of
exhalation. The numeric data display range is
from 0 to 30.
•
2 - PLAT (Plateau) Breathing Pressure
The breathing pressure at the end of
inspiration. The numeric data display range is
from 0 to 80.
2 - MEAN Breathing Pressure
The average of all the instantaneous pressure
values recorded during each breath. The
numeric data display range is from 0 to 50.
•
3 - PEAK Breathing Pressure
The highest instantaneous pressure value for
each breath. The numeric data display range is
from 0 to 80.
•
4 - Pressure High Alarm Limit
•
5 - Pressure Threshold Alarm Limit
•
6 - Breathing Pressure Trace Window
This large window displays a breathing
pressure trace, or waveform.
•
7 - Breathing Pressure Threshold Limit Line
•
8 - Breathing Pressure Minimum and
Maximum Trace Scale Limits Indicator
Figure 86. Breathing Pressure Monitor Data
4
1
8
2
3
5
6
7
77
Breathing Pressure Monitor Controls
The Alarm Limits key (1) and the rotary knob (2)
enable you to set breathing pressure alarm limits.
Figure 87. Breathing Pressure Monitor Controls
1
2
Setting the Pressure and Threshold
Alarm Limits
At power-up and when you press the Restore Default
Settings key on the Standby screen, the breathing
pressure high and pressure threshold alarm limits are
automatically set to their default settings. You can
adjust these limits within specified ranges.
Pressure Threshold Alarm Limit
The Pressure Threshold Limit range is from
5 to 30 cmH2O.
Factory default value: 8 cmH2O.
The pressure threshold alarm limit defines the level
below which an apneic alarm condition exists. When
the patient's breathing pressure falls below the
threshold limit for 15 seconds, a message appears in
the Alarm window and an audible alarm sounds.
Note: The pressure threshold alarm limit should be
as close as possible to the sensed peak
pressure without exceeding it, approximately
6 cmH2O below the peak pressure.
Procedure
See “Alarms” on page 65 to change the pressure
high alarm limit.
78
Breathing Pressure Alarm Messages
The following list contains all warning, caution and
advisory alarms associated with breathing pressure
monitoring.
PRES APNEA ALARM OFF
The apnea pressure alarm is disabled.
APNEA PRESSURE (Warning/Caution)
When the ventilator is on:
If the measured breathing pressure does not
cross the pressure threshold alarm limit for more
than 15 seconds, the Caution message APNEA
PRESSURE!! appears in the Alarm window and
If the breathing pressure does not cross the
pressure threshold for an additional 15 seconds
(30 seconds total), the Caution message APNEA
PRESSURE!! is upgraded to a Warning in the
Alarm window (APNEA PRESSURE!!!), and a
continuously repeating audible alarm sounds.
When the system is in ManSpont Mode:
The APNEA PRESSURE alarm is automatically
deactivated. The APNEA PRESSURE alarm can
be activated. When it is activated in ManSpont
mode, the Caution occurs after 30 seconds, and
the Warning occurs after 60 seconds.
CONTINUOUS PRESSURE (Warning)
If the measured breathing pressure remains above
the pressure threshold alarm limit for more than 15
seconds, the breathing pressure display area is
cleared, the Warning message CONTINUOUS
PRESSURE!!! appears in the Alarm window, and a
continuous audible alarm sounds.
When the measured breathing pressure drops below
the pressure threshold alarm limit, alarm
annunciation ceases.
AIRWAY PRESSURE HIGH (Warning)
If the measured breathing pressure exceeds the high
pressure limit, the Warning message AIRWAY
PRESSURE HIGH!!! appears in the Alarm window
and a continuously repeating audible alarm sounds.
This alarm condition is cleared when the measured
breathing pressure drops below the high pressure
alarm limit. However, the alarm message is extended
for 10 seconds to allow for a momentary high
pressure condition.
79
PRESSURE NEGATIVE (Warning)
If the measured breathing pressure falls below
-5 cmH2O or mean pressure falls below -2 cmH2O,
the Warning message PRESSURE NEGATIVE!!!
appears in the Alarm window and a continuously
repeating audible alarm sounds.
This alarm condition is cleared when the sensed
pressure rises above -5 cmH2O or above a mean
pressure of -2 cmH2O. However, the alarm message
is extended for 10 seconds to allow the recognition of
a momentary subatmospheric pressure condition.
EXP PRESSURE HIGH (Caution)
During Volume or Pressure Ventilation (Caution)
Any time that the monitor measures a PEEP of
4 cmH2O over the PEEP setting, the Caution
message EXP PRESSURE HIGH!! appears in the
Alarm window and an intermittent audible alarm
sounds.
PEEP HIGH (Advisory)
During ManSpont Mode (Advisory)
Alarm annunciation occurs when the measured
PEEP is greater than 4 cmH2O.
INSP PRES NOT REACH (Advisory)
Any time that PINSP pressure is not reached in
Pressure mode, the Advisory message INSP PRES
NOT REACH! appears in the Alarm window.
PRESSURE SENSOR FAIL (Advisory)
If the Fabius GS detects a faulty sensor, the Advisory
message PRESSURE SENSOR FAIL! appears in the
Alarm window. If this happens, call your local
Authorized Service Organization or DrägerService
(see “Daily and Preuse Checkout Form” for
DrägerService contact information).
PRESSURE LIMITING (Advisory)
Any time that the monitor detects pressure greater
than or equal to the PMAX setting, Advisory message
PRESSURE LIMITING! appears in the Alarm
window. This advisory can only occur when the
ventilator is in Volume Control mode.
PRES THRESHOLD LOW (Advisory)
The Advisory message PRES THRESHOLD LOW
appears in the Alarm window any time the sensed
peak pressure exceeds the threshold pressure alarm
limit by more than 6 cmH2O at threshold pressure
alarm limit settings of 5–20 cmH2O, or by more than
80
8 cmH2O at threshold pressure alarm limit settings of
21–29 cmH2O. Setting the threshold pressure alarm
limit at 30 cmH2O disables the PRES THRESHOLD
LOW advisory.
Problem Resolution
Table 5. Breathing Pressure Monitoring Problem Resolution
PROBLEM
POSSIBLE CAUSE
REMEDY
No pressure readout in
display area during
ventilation
Pilot line not connected.
Make sure pilot line is
properly connected.
Pilot line blocked or kinked.
Make sure that lumen of pilot
line is free of obstructions.
Condensation accumulation
in pilot line.
Drain and reconnect pilot
line.
Erratic readings
81
Chapter 7 - Setup Window (Used During Operation)
Contents
Setup Window (Used During Operation)
Contents
Overview ................................................................................................................. 85
Setup Window Access ............................................................................................. 85
Auto Set ................................................................................................................... 86
Calibrate O2 Sensor ................................................................................................ 86
Activate Des Comp .................................................................................................. 87
Access Alarm Log ................................................................................................... 88
Access Alarm Volume ............................................................................................. 88
Window Deactivation ............................................................................................... 88
83
Overview
Overview
This chapter describes the monitoring and ventilation
functions available in the Setup window, which can
be used in Volume Control, Pressure Control, and
ManSpont mode.
The Setup window enables you to
•
perform ventilation functions and
•
view and change monitoring settings for
the current operation.
Note: To set default monitoring settings to be
used at the power-up of each operation,
see “Standby Setup Screen” on page 95.
Setup Window Access
Press the Setup key (1 in Figure 88) while the
ventilator is in Volume Control, Pressure Control, or
ManSpont ventilation mode.
The Setup window (1 in Figure 89) replaces the
Waveform area and the soft key labels
(2 and 3 in Figure 88).
1
2
3
The following soft key labels appear in the Setup
window:
•
Auto Set
•
Calibrate O2 Sensor
•
Activate Des Comp
•
Access Alarm Log
•
Access Alarm Volume
1
85
Auto Set
Auto Set
Press the Auto Set soft key.
The breathing pressure threshold is set to 4 cmH2O
below the current Peak pressure data value.
Note: The threshold setting may not be less than
5 cmH2O or greater than 30 cmH2O.
Note: In the absence of a current Peak pressure
data value, pressing the softkey will have no
effect.
Calibrate O2 Sensor
1. Press the Calibrate O2 Sensor soft key.
(Figure 90) replaces the Setup window.
2. Follow the instructions and press the rotary knob.
The present O2 value is replaced by “CAL”
(1 in Figure 91).
1
Upon completion of the calibration, the O2
concentration measurement appears.
If the O2 sensor can not be calibrated, replace the O2
capsule in the O2 sensor housing (see “Inserting A
New O2 Sensor Capsule” on page 46.
If the O2 sensor still can not be calibrated, call your
local Authorized Service Organization or
DrägerService (see “Daily and Preuse Checkout
Form” for DrägerService contact information).
86
Activate Des Comp
Activate Des Comp
Press the Activate Des Comp soft key.
Figure 92. Setup Des Comp Activated
2
Desflurane compensation is Activated.
When the Activate Des Comp soft key is pressed, its
soft key label changes from “Activate Des Comp” to
“Deactivate Des Comp” (1 in Figure 92). “Des ON”
appears at the top of the Setup window
(2 in Figure 92).
The Desflurane compensation state will not change
when you restore site defaults or run system
diagnostics.
Note:
Desflurane has characteristics that affect
the sensitivity of the Fabius GS flow
sensor. To help assure that the volume
measurements from the monitor are
accurate, select "ACTIVATE DES
COMP" when Desflurane is used in the
breathing circuit. The Fabius GS will
automatically compensate for the
change in flow measurement
characteristics caused by the use of
Desflurane.
1
Caution: Ensure that Desflurane compensation is
only activated whenever Desflurane is
used. Failure to activate when
Desflurane is used will affect measured
volume accuracy. Activating when
Desflurane is not used will affect
measured volume accuracy.
Caution: The Fabius GS will automatically
compensate for Desflurane when agent
concentration data is available through
communication with an external agent
analyzer. Inaccurate data from the
analyzer may affect measured volume
accuracy.
Note:
If Desflurane concentration data is
communicated to the Fabius GS by an
external agent analyzer, the Fabius GS
will automatically perform the
corresponding flow compensation. In this
case, the communicated data always
overrides the functionality of the
Desflurane compensation softkey.
87
Access Alarm Log
Access Alarm Log
Figure 93. Setup Alarm Log
Press the Access Alarm Log soft key.
The alarm log (Figure 93) replaces the Setup
window.
Turn the rotary knob to scroll down the list of alarm
messages.
Note: If “Clear Alarm Log” is selected and
confirmed, all alarm messages in the Alarm
Log are deleted.
Access Alarm Volume
Figure 94. Setup Alarm Volume
1. Press the Access Alarm Volume soft key.
The Alarm Volume Setting window (Figure 94)
replaces the Setup window.
2. Select and confirm a new alarm volume value.
The new alarm volume value is saved and the
Access Alarm Volume Setting window
disappears.
Note: The value “1” is the minimum and the value
of “10” is the maximum.
Window Deactivation
88
Once the Setup window is activated, if no rotary knob
activity occurs within 15 seconds, the Setup window
is deactivated and the Waveform window is
activated. Another way to deactivate the Setup
window and activate the Waveform window is to
press the Home key.
Chapter 8 - Standby Mode Functions
Contents
Standby Mode Functions
Contents
Overview ................................................................................................................. 91
Standby Screen ....................................................................................................... 91
Access .................................................................................................................. 91
Sleep Mode .......................................................................................................... 92
Run System Test .................................................................................................. 92
Calibrate Flow Sensor .......................................................................................... 92
Calibrate O2 Sensor ............................................................................................. 93
Leak / Compliance Test ........................................................................................ 93
Access Alarm Log ................................................................................................. 94
Restore Site Defaults ............................................................................................ 94
Standby Setup Screen ............................................................................................. 95
Default Settings .................................................................................................... 95
Configuration ...................................................................................................... 101
89
Overview
Overview
This chapter describes the functions that are made
available in Standby mode.
Standby Screen
Figure 95. Standby Confirmation Message and Gas Flow
Control Valve Shut Off Message Window
Access
1. Press the Standby key.
The Standby Confirmation Message and Gas
Flow Control Valve Shut Off Message window
(1 in Figure 95) replaces the Waveform window.
The LED associated with the Standby key starts
blinking. It remains blinking until Standby is
confirmed by pressing the rotary knob.
Note: If confirmation does not occur within 15
seconds, the Standby Confirmation
Message and Gas Flow Control Valve
Shut Off Message window are
deactivated and the Waveform window is
activated. The Ventilator will not be
switched to Standby mode.
2. Confirm.
1
The Standby screen (Figure 96) replaces the
previous screen.
After the Standby status is confirmed,
•
The Standby key’s LED is switched from
blinking to constantly on, and the ventilator
is switched to Standby mode.
•
If fresh gas flow is detected, then the flows
were not shut off before activating Standby
mode and the “Gas still flowing!” alarm
message will appear in the alarm window
(Figure 96). Once all gas flow control
valves are shut off, the flow detection
alarm message disappears (Figure 97).
91
Sleep Mode
Standby Screen
Figure 98. Sleep Mode Screen
If 5 minutes elapse in Standby mode with no user
input, SLEEP mode is activated (Figure 98). The
Ventilator monitor screen is replaced by the screen
saver. The Screen Saver displays a message that
provides instructions on how to activate Standby
mode.
Run System Test
Figure 99. Diagnostics Screen
Press the Run System Test soft key.
The system diagnostics is performed (Figure 99).
After successful completion, the system switches to
the Standby screen.
Calibrate Flow Sensor
Figure 100. Calibrate Flow Sensor Instruction Screen
1. Press the Calibrate Flow Sensor soft key.
The Calibrate Flow Sensor Instruction window
replaces the Standby screen soft key labels
(Figure 100).
2. Follow the instructions.
Figure 101. Calibrate Flow Sensor in Progress Bar
3. Upon completion of the calibration, the “Flow
Sensor Calibration completed” message (Figure
102) or the “Flow Sensor Calibration FAILED”
message (Figure 103 on page 92) appears.
Figure 102. Calibrate Flow Sensor Completed Bar
Flow Sensor Calibration Failed - Troubleshooting
Figure 103. Calibrate Flow Sensor Failed Bar
If the Flow sensor can not be calibrated, retry the
calibration.
If the Flow sensor still can not be calibrated, call your
92
The Calibrate Flow Sensor in Progress bar
replaces the instruction window (Figure 101).
Standby Screen
Calibrate O2 Sensor
1. Press the Calibrate O2 Sensor soft key.
replaces the Standby screen soft keys
(Figure 104).
2. Follow the instructions.
The Calibrate O2 Sensor in Progress bar
replaces the instruction window (Figure 105).
3. Upon completion of the calibration, the “O2
Sensor Calibration completed” message
(Figure 106) or the “O2 Sensor Calibration
FAILED” message (Figure 107) appears.
Figure 106. Calibrate O2 Sensor Completed Bar
O2 Sensor Calibration Failed - Troubleshooting
Figure 107. Calibrate O2 Sensor FAILED Bar
If the O2 sensor can not be calibrated, replace the O2
capsule in the O2 sensor housing (see “Inserting A
New O2 Sensor Capsule” on page 46).
If the O2 sensor still can not be calibrated, call your
Leak / Compliance Test
Figure 108. Leak / Compliance Test Vent Prep Message
1. Press the Leak / Compl Test soft key.
The Leak / Compl Test Ventilator Preparation
message replaces the Standby screen
(Figure 108), followed by the Leak / Compl Test
Instruction screen (Figure 109).
2. Follow the instructions on the Leak / Compl Test
Instruction screen.
Figure 109. Leak / Compliance Test Instruction Screen
Upon completion of the instructions, the
Leak / Compl Test Results screen appears
(Figure 110 on page 94).
93
Standby Screen
Figure 110. Leak / Compliance Test Results Screen
Access Alarm Log
Figure 111. Standby Screen Alarm Log
1. Press the Access Alarm Log soft key.
The Alarm Log appears (Figure 111).
2. Turn the rotary knob to scroll through the Alarm
Log.
When the “Clear Alarm Log” is selected and
confirmed, all alarms in the Alarm Log are deleted.
Restore Site Defaults
Figure 112. Site Defaults Restored Bar
Press the Restore Site Defaults soft key. The predefined site default settings are restored, and the
“Default settings restored” message appears
(Figure 112).
Site default settings are set in the Standby Setup
screen.
94
Standby Setup Screen
In Standby mode, press the Setup key.
The Standby Setup screen (Figure 113) replaces the
Standby Screen.
The cursor, which appears over “Default Settings,”
enables you to select “Default Settings” or
“Configuration”.
Default Settings
Select and confirm “Default Settings.”
Figure 114. Standby Setup Screen Default Settings
Selected
The Default Settings column is selected (Figure 114).
If the return arrow (1 in Figure 114) is selected and
confirmed, the Default Settings column is deselected and “Default Settings” is selected
(Figure 113).
1
The Default Settings Items are:
Volume settings
•
Pressure settings
•
Alarm Limits
•
Alarm Volume
•
Restore Factory Defaults
•
95
Volume Settings
Figure 115. Standby Setup Screen Default Volume
1. Select and confirm “Volume settings.”
The Default Volume Settings window appears
along the bottom of the Standby Setup screen
(Figure 115).
2. Press a soft key (ex., PMAX in Figure 116).
Figure 116. Standby Setup Screen Default Volume Change
The cursor appears over the setting for the
selected soft key.
3. Select and confirm a new setting value (ex., in
Figure 116, the setting value was changed from
40 to 50).
The Standby Setup screen instructs you to
confirm the new default setting (Figure 117).
4. Repeat steps 2 and 3 for setting other parameter
values.
5. Confirm the new default setting.
The Default Volume Ventilator Settings window
disappears, and the cursor appears over the
return arrow.
Figure 117. Standby Setup Screen Default Volume Change
Saved
Pressure Settings
Use the process example in “Volume Settings” and
replace “Volume settings” with “Pressure settings.”
96
Alarm Limits
1. Select and confirm “Alarm Limits.”
The Default Alarm Limits window appears
(Figure 118).
2. Select and confirm the desired alarm limit
(Figure 119).
Select
3. Select a new setting value (ex., in Figure 120,
the setting value was changed from 30 to 25).
Confirm
4. Confirm the new setting value.
The new setting is saved and the cursor appears
over the return arrow.
5. Repeat steps 2 through 4 for setting other setting
values.
97
Setting Alarm Limit Defaults
When the anesthesia machine is started, it uses the
default alarm limit values that were established the
last time the machine was configured. These values
can be viewed and changed in the Alarm Limit
window.
The Alarm Limit window is deactivated if the rotary
knob is not used within 15 seconds, if the Alarm
Limit key is pressed again, or if any other key is
pressed.
Alarm Variables
Oxygen High Limit — The Oxygen High
Alarm Limit range is from 19% to 100%. It is
not possible to set the Oxygen High Limit
setting to less than or equal to the Oxygen Low
Limit.
The factory default value for Oxygen High
Limit is 100%.
•
Oxygen Low Limit — The Oxygen Low Alarm
Limit range is from 18% to 99%. It is not
possible to set the Oxygen Low Limit setting to
equal to or greater than the Oxygen High Limit.
The factory default value for Oxygen Low
Limit is 20%.
•
Minute Volume High Limit — The Minute
Volume High Limit range is from
The factory default value is 12.0 L/min.
•
Minute Volume Low Limit — The Minute
Volume Low Limit range is from 0.0 L/min. to
19.9 L/min.
The factory default value is 3.0 L/min.
•
Pressure High Limit — The Pressure High
Limit range is from 10 to 70 cmH2O.
The factory default value is 40 cmH2O.
•
Apnea Pressure Threshold — The Apnea
Pressure Threshold Limit range is from 5 to
30 cmH2O.
The factory default value is 8 cmH2O.
98
•
Alarm Volume
Figure 121. Standby Setup Screen Default Alarm Volume
1. Select and confirm “Alarm Volume.”
The Default Alarm Volume Setting window
appears next to “Alarm Volume” (Figure 121).
2. Select and confirm a new alarm volume value
(ex., in Figure 122, the value is changed from
“4” to “5”).
Figure 122. Standby Setup Screen Default Alarm Volume
The new alarm volume value is saved and the
Default Alarm Volume Setting window
disappears.
Note: The value “1” is the minimum and the value
of “10” is the maximum.
99
Restore Factory Defaults
Figure 123. Restore Factory Defaults
1. Select and confirm “Restore Factory Defaults.”
The Restore Factory Defaults Setting window
appears next to “Restore Factory Defaults”
(Figure 123).
2. Select and confirm “Yes” or “No.”
When “Yes” is selected and confirmed, the
factory defaults are restored and replace the
Default Settings.
The factory default settings:
Volume Control
•
PMAX = 40
•
VT = 600
•
Freq = 12
•
TI : TE = 1:2.0
•
TIP : TI = 10
•
PEEP = 0
Pressure Control
•
PINSP = 15
•
Freq = 12
•
TI : TE = 1:2.0
•
Insp Flow = 30
•
PEEP = 0
Alarm Default Settings for O2
High = 100
•
Low = 20
•
Alarm Default Settings for MV
•
High = 12.0
•
Low = 3.0
Alarm Default Settings for Pressure
•
High = 40
•
Threshold = 8
Alarm Audio Volume = 5
100
Configuration
Select and confirm “Configuration.”
Figure 124. Standby Setup Screen Configuration Settings
Selected
The Configuration column is selected (Figure 124).
If the return arrow is selected and confirmed, the
Configuration column is de-selected and
“Configuration” is selected.
The Configuration Items are:
•
Time Set
•
Time Format
•
Date Set
•
Date Format
•
Acoustic Confirmation
•
Alarm Tone Sequence
•
Waveform Display
Time Set
1. Select and confirm “Time Set.”
Figure 125. Standby Setup Screen Configure Time Hour
Select
The Time Set window appears to the right of
“Time Set” and the cursor appears over the hour
field (Figure 125).
2. Select and confirm a new hour time value (ex., in
Figure 126, the value is changed from
“13” to “20”).
The cursor moves over the minute field
(Figure 127).
101
3. Select and confirm a new minute time value
“15” to “30”).
Figure 127. Standby Setup Screen Configure Time Minute
The new time values are saved, the Time Set
window disappears, and the cursor in the
Configuration column appears over “Time Set.”
Note: This three-step process also applies to
“Date Set” on page 103.
Time Format
Figure 128. Standby Setup Screen Configure Time Format
1. Select and confirm “Time Format.”
The Time Format window appears to the right of
“Time Format” and the cursor appears over the
default time format value (Figure 125).
2. Select and confirm a new time format value
“24:00 Hour” to “AM/PM”).
The new format value is saved, the Time Format
window disappears, and the cursor in the
Configuration column appears over “Time
Format.”
The values that can be selected are
“24 Hour” or “AM/PM.”
Note: This two-step process applies to all other
items in the Configuration column except for
“Time Set” and “Date Set.”
102
Date Set
The values that can be selected are numerical values
applicable to day, month, and two-digit year.
Date Format
The values that can be selected are
“MM-DD-YY” or “DD-MM-YY.”
Acoustic Confirmation
The values that can be selected are “On” and “Off.”
Figure 130. Standby Setup Screen Configure Date Set
Select
Figure 131. Standby Setup Screen Configure Date Format
Select
Figure 132. Standby Setup Screen Configure Acoustic
Confirmation
If “On” is selected, an acoustic confirmation is
annunciated every time that the rotary knob is
pressed.
103
Alarm Tone Sequence
The values that you can select are ”Dräger” and
“EN 740.”
Waveform Display
Figure 133. Standby Setup Screen Alarm Tone Sequence
Select
Figure 134. Standby Setup Screen Waveform Display
The values that you can select are “Normal” and
“Filled.”
If “Normal” is selected, the waveform is not filled with
a solid pattern, but appears as a line
(1 in Figure 135).
Figure 135. Normal Waveform Display
104
1
Chapter 9 - Routine Maintenance and Cleaning
Contents
Routine Maintenance and Cleaning
Contents
Routine Maintenance ............................................................................................ 107
Disassembling ....................................................................................................... 107
Preparing the Compact Breathing System ......................................................... 107
Dismantling the Inspiratory Valve ....................................................................... 107
Dismantling the Expiratory Valve ........................................................................ 107
Dismantling the Flow Sensor .............................................................................. 107
Dismantling the APL-Valve ................................................................................. 107
Dismantling the Absorbent Canister ................................................................... 108
Dismantling Parts of the Ventilator ..................................................................... 108
Disinfecting/Cleaning/Autoclaving ......................................................................... 109
Recommendations for Typical Cleaning and Disinfection After Use .................. 110
Maintenance Intervals ............................................................................................ 111
When Required .................................................................................................... 111
Every 6 Months .................................................................................................... 111
Annually ............................................................................................................... 111
After 3 Years ........................................................................................................ 111
Checking Readiness for Operation ........................................................................ 111
105
Routine Maintenance
Routine Maintenance
Routine maintenance must be performed regularly to
ensure safe and effective operation. Regularly check
the condition of the absorbent and the overall
condition of the machine, power cord, hoses, and
breathing bag.
Disassembling
Preparing the Compact Breathing
System
1. Leave the Dräger Vapor(s) on the machine.
2. Remove all breathing hoses.
3. Remove the breathing bag.
4. Remove the ventilation hose.
5. Remove the fresh gas hose from the breathing
system.
6. Remove the anesthetic scavenging hose.
7. Detach the APL-bypass and the Peep/Pmax
lines from the breathing system and from the
side of the machine.
8. Remove the flow sensor cable.
9. Remove the O2 sensor cable.
10. Remove the compact breathing system.
Dismantling the Inspiratory Valve
1. Unscrew the retaining nut.
2. Remove the inspection cap.
3. Extract the valve disc.
Dismantling the Expiratory Valve
2. Remove the inspection cap.
3. Extract the valve disc.
Dismantling the Flow Sensor
1. Loosen fitting on the expiration port.
2. Extract the flow sensor.
Dismantling the APL-Valve
2. Remove the APL-valve.
3. Unscrew the waste gas outlet port.
107
Disassembling
Dismantling the Absorbent Canister
1. Turn the absorber counter-clockwise and remove
by pulling down.
2. Empty the expired CO2 absorbent from the
absorber into an appropriate refuse container.
Warning: Absorbent is caustic and is a strong
irritant to the eyes, skin, and respiratory
tract. When replacing the absorbent,
take care not to spill its caustic contents.
3. Fill the absorber with fresh CO2 absorbent.
sealing surfaces. Such dust and particles can
Dräger recommends the use of Drägersorb 800 Plus.
Dismantling Parts of the Ventilator
Figure 136. Dismantling the Ventilator
The following numbers in boldface refer to Figure
136.
1. Swing out the ventilator door (1).
2. Disconnect the ventilator chamber pressure
sensor line (2) from the ventilator chamber
pressure sensor line port (3).
5
3. Unlock the three clasps (4) to remove the cover
(5).
4. Remove the diaphragm (6).
A B
3
2
4
6
1
108
Disinfecting/Cleaning/Autoclaving
Clean and autoclave the Fabius GS Anesthesia
Workstation and its parts according to the guidelines
below. Follow your institution's policies regarding
specific methods and agents for cleaning and
sterilization. Determination of the need and
frequency of sterilization of any particular component
is the responsibility of the user institution.
Autoclaving procedures should be performed
according to procedures established by the user
institution following the specific instructions provided
by the manufacturer of the sterilizing equipment or
agent to be used. Such policies, procedures, and
instructions should ultimately be consistent with
established principles of clinical microbiology and
infection control.
Caution: The exterior and certain other
components of the anesthesia
workstation consist of materials that are
sensitive to certain organic solvents
sometimes used for cleaning and
disinfecting (e.g., phenols, halogen
releasing compounds, oxygen releasing
compounds, strong organic acids, etc.).
Exposure to such substances may
cause damage that is not always
immediately apparent. Sterilization with
ethylene oxide (EtO) or formaldehyde is
also not permitted.
To prevent any damage, we recommend that only
detergents and disinfectants are used that are
compatible with the device, e.g. surface disinfectants
on the basis of aldehydes, alcohols, or quarternary
ammonium compounds for disinfection.
Ensure that all disinfectants are registered with the
U.S. Environmental Protection Agency (or approved
by your national authorities) for use as intended.
Always follow the instruction labels specifically with
respect to prescribed concentrations and the
necessary exposure times.
Disinfectants often contain – besides their main
active agents – additives that can also damage
materials. When in doubt, ask the supplier/
manufacturer of the disin-fectant/cleaning agent.
Caution: The Fabius GS and its components must
not be treated with formaldehyde vapors
or ethylene oxyde!
Warning: Follow all of your accepted hospital
procedures for disinfecting parts
contaminated with body fluids (protective
clothing, eyewear, etc.).
109
Recommendations for Typical Cleaning and Disinfection After Use
A
B
Washing Machine (Wet pasturization at 70° C, 158° F, for 30 minutes after detergent cleaning)
Wiping (Glutaraldehyde-based formultations of 2%; ethyl or isopropyl alcohol at 70% to 90%;
sodium hypochlorite (5.2% household bleach) 1:500 dilution (100 ppm free chlorine))
C Immersion (Glutaraldehyde-based formultations of 2%)
D Autoclaving (Including steam or hot air at 134° C, 273° F). Use your manufacturer’s or your facility’s
recommendations.
1 Per patient
2 Daily
3 Weekly
4 Monthly
* Front daily, other surfaces weekly
Table 6. Schedules for Fabius GS Anesthesia Workstation
Components Processed
Schedules
A
B
Workstation (outside)
B*
Vaporizers
B2
Power cable, gas supply
hoses
B4
C
B1
D
Breathing bag and hose and
Y-piece
A1
D1
Diaphragm
A1
C1
D1
Breathing system
A1
C1
D1
Valve discs
A1
C1
D1
D1
Ventilator cover
D1
APL-valve
D1
Exhaust port
D1
Control lines and cables
(outside)
B3
Expiratory port
A1
C1
D1
Absorber and insert
A1
C1
D1
Flow sensor (outside)
AGS housing
B2
A1
AGS flow tube (no filter)
C2
C1
B1
D1
D1
AGS buffer vol. container
A1
C1
D1
AGS transfer hose
A1
C1
D1
110
Ventilator hose
Maintenance Intervals
Maintenance Intervals
Clean and disinfect the machine and components
before each service (and also when returning for
repair).
When Required
•
•
•
•
•
Replace the O2 sensor when calibration is no
longer possible.
Replace the flow sensor when calibration is no
longer possible.
Replace the pressure-measuring line (silicone
rubber hose and sleeve).
Replace APL-bypass and PEEP and Pmax
silicone rubber hoses.
Replace the ventilator hose if it is discolored or
damaged.
Every 6 Months
Inspection and service by trained service personnel.
Draeger Medical, Inc. recommends DrägerService.
•
•
•
•
•
Fabius GS
Breathing systems
Dräger Vapor
Sensors
Ventilator hose
Annually
•
•
•
Replace the bacterial filter on the pressuremeasuring line.
Replace the diaphragm in the ventilator
(patient).
Replace Vapor O-Rings
After 3 Years
By trained service personnel:
•
•
•
Replace the lead gel rechargeable battery for
the back-up power supply.
Replace the diaphragm and O-rings of the
ventilator (piston).
Replace breathing system canister assembly
and associated seals.
Checking Readiness for Operation
Refer to “Daily and Preuse Checkout Form” in the
Appendix.
111
Chapter 10 - Troubleshooting
Contents
Troubleshooting
Contents
Table 8. Alarm Message, Probable Cause, and Remedy ...................................... 115
113
Contents
Table 7. Alarm Message, Probable Cause, and Remedy
Alarm Message
Probable Cause
AIRWAY PRESSURE HIGH
Upper alarm limit for airway pressure has Check hose system on anesthesia machine.
been exceeded, ventilation hose is kinked.
Alarm limit has been set too low.
Check breathing circuit or alarm limit value.
APNEA FLOW
Breathing/ventilation stops.
Leak or disconnect in breathing circuit.
Check ventilator.
Check breathing circuit.
APNEA PRESSURE
Inadequate fresh-gas supply.
Breathing/ventilation stops.
Ensure adequate fresh-gas supply.
Check ventilator.
BATTERY LOW
AC failure and battery < 20% = Advisory
AC failure and battery < 10% = Caution
Restore mains power.
CHECK BATTERY
UPS is not functional.
Replace fuse.
Call your local Authorized Service Organization or
CONTINUOUS PRESSURE
Breathing pressure above threshold for
more than 15 seconds.
Check breathing circuit. If in ManSpont mode,
check fresh gas flow.
EXP PORT LEAKAGE
Expiratory flow of more that 15 mL
measured during inspiration.
Check expiratory valve and valve disk.
Check tubing of expiration control line.
Follow the procedure to calibrate flow sensor.
EXP PRESSURE HIGH
Peep is 4 cmH2O above the Peep setting
in an automatic ventilation mode.
Check PEEP/PMAX, etc. hoses for kinks.
FLOW SENSOR CAL DUE
More than 18 hours passed since last flow Follow the procedure to calibrate flow sensor.
sensor calibration.
FLOW SENSOR FAIL
Flow sensor has not been calibrated.
Sensor faulty.
Follow the procedure to calibrate sensor.
Replace sensor and calibrate.
FRESH GAS LOW
Blocked/kinked hose.
Check hoses.
INSP O2 HIGH
Inspiratory O2 concentration exceeds the
upper alarm limit.
Check flowmeter settings and O2 high alarm limit.
INSP O2 LOW
Inspiratory O2 concentration is below
lower alarm limit.
Check O2 supply. Check flowmeter settings and
O2 low alarm limit.
INSP PRES NOT REACH
Set pressure not achieved while ventilating Check ventilator and Pinsp settings.
in Pressure Control mode.
MINUTE VOLUME HIGH
Minute volume has exceeded upper alarm Calibrate flow sensor.
limit.
Replace if necessary.
Flow sensor has not been calibrated.
Sensor faulty.
Remedy
115
Contents
Alarm Message
Probable Cause
Remedy
MINUTE VOLUME LOW
Minute volume has fallen below lower
alarm limit.
Blocked/kinked hose.
Leak in breathing system.
Reduced volume due to pressure
limitation.
Reduced lung compliance.
Flow sensor not calibrated or faulty.
Check breathing circuit and alarm limit.
NO FRESH GAS
Fresh-gas control valve closed
Open fresh-gas control valve.
O2 SENSOR CAL DUE
More than 18 hours passed since last
oxygen sensor calibration.
Follow the procedure to calibrate oxygen sensor.
O2 SENSOR FAIL
O2 sensor has not been correctly
calibrated.
O2 sensor replaced and/or not calibrated.
O2 sensor used up.
O2 sensor disconnected.
Faulty sensor cable.
Follow the procedure to calibrate O2 sensor.
Check breathing system.
Check Pmax setting on ventilator control panel.
Check ventilator settings.
Follow the procedure to calibrate flow sensor and
replace if necessary.
Follow the procedure to calibrate O2 sensor.
Replace sensor capsule and calibrate.
Connect O2 sensor assembly.
Replace O2 sensor housing assembly.
O2 SUPPLY LOW
Check O2 supply and cylinder backup.
O2 supply line has less than minimum
pressure permitted (approximately 20 psi).
PEEP HIGH
Peep is higher than 4 cmH2O in ManSpont Check APL-valve setting and/or fresh gas flow.
mode.
POWER FAIL
Mains not connected.
Facility power failure.
PRES APNEA ALARM OFF
Pressure alarms off in ManSpont.
PRESSURE LIMITING
Measured pressure equals or exceeds
Pmax ventilator setting.
Check ventilator and Pmax settings.
PRESSURE NEGATIVE
Measured breathing pressure is less than
-5 cmH2O.
Check breathing circuit and ventilator settings.
PRESSURE SENSOR FAIL
Faulty sensor or pressure not calibrated.
PRES THRESHOLD LOW
Ventilation parameters were changed
without changing alarm settings.
Breathing pressure leak or partial
disconnection occurs when the threshold
pressure alarm limit is set significantly
lower than the peak pressure.
Push the Auto Set soft key and check ventilator
settings.
RS232 COM FAIL
External monitor cable disconnected.
Check monitor interface cable.
SPEAKER FAIL
Primary speaker failed.
VENTILATOR FAIL
Ventilator not assembled correctly.
Check diaphragm and close cover.
Check PEEP/PMAX line for disconnect or leak.
Select Standby Mode and switch back to the
previous ventilation mode.
VOLUME ALARMS OFF
Volume alarms turned off by operator in
ManSpont mode.
116
Connect mains.
Chapter 11 - Components
Contents
Components
Contents
Front View ............................................................................................................. 119
Compact Breathing System (Top View) ................................................................. 120
Rear View (3-Gas Supply Connections) ................................................................ 121
117
Front View
Front View
Figure 137. Compact Breathing System and Front of Machine
10
6
2
1
3
4
6
9
5
8
7
11
1 O2 sensor on inspiratory valve
2 Inspiratory valve
3 Switching lever MAN and SPONT on pressure
limiting valve
4 Pressure-limiting valve for manual ventilation
(APL valve)
5 Airway pressure gauge
6 Dräger Vapor anesthetic agent vaporizer
7 Oxygen flush
8 Total fresh gas flowmeter
9 Ventilator
10 Ventilator control panel (settings for ventilation
parameters and airway monitoring)
11 Ventilator hose
119
Compact Breathing System (Top View)
Compact Breathing System (Top View)
Figure 138. Compact Breathing System
5
7
2
3
6
8
4
1
9
1 Plunger
2 Switching lever MAN and SPONT on pressure
limiting valve
3 APL Bypass valve connection port
4 PEEP/PMAX valve connection port
5 Inspiratory valve
6 Expiratory valve
7 Inspiratory port
8 Connector for breathing bag
9 Expiration port
120
Rear View (3-Gas Supply Connections)
Rear View (3-Gas Supply Connections)
Figure 139. Compact Breathing System and Back of Machine
4
1
2
3
5
1 Power cable
2 On/off switch
3 Fuse
4 Connectors for medical gas pipeline supply (central supply)
5 Connectors for gas cylinder supply (reserve supply)
121
Chapter 12 - Technical Data
Contents
Technical Data
Contents
Technical Data ....................................................................................................... 125
Ambient Conditions ............................................................................................ 125
Machine Data ..................................................................................................... 125
Fuses .................................................................................................................. 126
Electromagnetic Compatibility (EMC) ................................................................. 126
Electrical Safety Conformance ........................................................................... 126
Ventilator ............................................................................................................. 127
Anesthesia Gas Supply Module ......................................................................... 128
Anesthetic Agent Vaporizer Interface ................................................................. 129
Breathing System ............................................................................................... 130
Low Oxygen Supply Pressure Alarm .................................................................. 130
S-ORC (Sensitive Oxygen Ratio Controller) ....................................................... 131
Serial Interface ................................................................................................... 131
Diagrams ............................................................................................................... 132
123
Technical Data
Technical Data
Ambient Conditions
During operation
Temperature
Atmospheric pressure
Relative humidity
10 to 35 °C
700 to 1060 cmH2O
20 to 80%
During storage
Temperature
Atmospheric pressure
Relative humidity
–10 to 60 °C
700 to 1060 cmH2O
10 to 90%
Machine Data
Gas supply from medical gas pipeline system
Pipeline System Pressure Range at Machine Connector
O2, N2O, Air:
50 to 55 psi (3.4 to 3.8 bar)
Note: Pipeline system supply pressure variation
shall not exceed ± 10%
Gas supply connectors:
NIST or DISS (where required)
Each inlet is fitted with a non-return valve
± 3% of full scale from 40 to 120 psi (2.7 to 8 bar)
Pipeline Pressure Indicator Accuracy
Piping Pressure Relief (Canada)
< 75 psi (520 kPa)
Gas supply from supplementary O2 and N2O cylinders (with pin-index connections)
Cylinder Connections
Pin-indexed hanger yokes (CGA V-1-1994)
Cylinder Gas Pressure
O2, AIR
1900 psi (131 bar)
(typical full loads at 70 ºF, 21 ºC)
N 2O
745 psi (51.3 bar)
Cylinder Gauges
Conform to ASME B40.1 Grade B
Cylinder Gauge Range
O2
0 to 3000 psi (206.8 bar)
N 2O
0 to 3000 psi (206.8 bar)
AIR
0 to 3000 psi (206.8 bar)
Internal Regulator Safety Relief Valve
Pressure
70 psi
Equipment Class
m Class 1, Type B, IPX0
Ingress of Fluids
IPX0
125
Technical Data
Dimensions and Weight (Approximate)
Weight:
Base unit with COSY and without
224 lbs. (101.6 kg)
supplementary cylinders and vaporizers
Dimensions (with COSY)*:
(W) 89 cm x (H) 130.8 cm x (D) 84 cm
Dimensions (without COSY):
(W) 69 cm x (H) 130.8 cm x (D) 82 cm
* Note: Width may vary with COSY arm position.
Power supply, Rating Non-configurable
100 – 240 Vac, 50/60 Hz., 2.3 A maximum
Rechargeable batteries
Rating:
Type:
Recharging time:
Operation time with fully charged batteries:
24 V; 3.5 Ah
sealed, gelled lead-acid
< 16 hours on the mains or full operation time
45 minutes, minimum
Fuses
Figure 140. Fuse Locations
Mains fuses:(1)
For 100-240V supply voltage:
2x T2.5AL 250V
IEC 127/III
Fuses located
on circuit board:
1x T1.6AL 250V
1x T4AL 250V
1x T2.5AL 250V
2
3
4
1
IEC 127/III (2)
IEC 127/III (3)
IEC 127/III (4)
5
Battery fuse:
1x T3.15AL 250V IEC 127/III (5)
Electromagnetic Compatibility (EMC)
Conforming to EN 60601-1-2 and IEC 601-1-2
The operation of this anesthetic workstation or
module may be adversely affected by electromagnetic
interference exceeding the levels specified in
EN 60601-1-2.
Electrical Safety Conformance
Conforms to:
•
•
•
•
126
UL2601
IEC 601-1
CAN/CSA No. 601-1
IEC 601-2-13
Technical Data
Ventilator
Control Inputs Ranges
Note:
P = Pressure Control mode only; V = Volume Control mode only
PMAX (V)
Pressure limiting
15 – 70 cmH2O (1 cmH2O resolution)
VT (V)
Tidal volume
20 – 1400 mL (10 mL resolution)
f
Breathing frequency
4 – 60 bpm (1 bpm resolution)
Ti/Te
Inspiration/expiration ratio 4 : 1 to 1 : 4
Tip/Ti (V)
Inspiration pause
0% - 50% (1% resolution)
PEEP
End-expiratory pressure
0 - 20 cmH2O (1 cmH2O resolution)
Pinsp (P)
Inspiratory pressure
5 - 60 cmH2O (1 cmH2O resolution)
Insp Flow (P)
Inspiratory flow
10 - 75 L/min (1 L/min resolution)
PMAX
Pressure limiting
± 5 cmH2O of setting
VT
Tidal volume
± 5% of setting or 20 mL, whichever is greater
(discharged to atmosphere, no compliance compensation)
f
Breathing frequency
± 1 bpm of setting
Ti/Te
Inspiration/expiration ratio ± 5% of setting
Tip/Ti (V)
Inspiration pause
± 25% of setting
PEEP
End-expiratory pressure
± 2 cmH2O* or ± 20% of setting, whichever is greater
Delivery Accuracy
High Pressure Safety Relief Valve
75 ± 5 cmH2O
Negative Pressure Safety Relief Valve (Ambient Air Inlet Valve)
-7.5 to -9 cmH2O
System Compliance Compensation Measurement
0.2 to 6.0 ml/cmH2O
+/- 0.2 ml/cmH2O or +/- 10% of actual compliance, whichever is greater
127
Technical Data
Anesthesia Gas Supply Module
Fresh Gas Flow Indicators:
O2, N2O, Air:
Range and accuracy: 0.0 to 12.0 L/min ± 10% of reading or 0.12 L/min
(into an ambient atmosphere of 14.7 psi (101.3 kPa) at 20° C).
Resolution: 0.1 L/min.
Fresh Gas Flow Stability:
O2 and N2O: ±10% of setting with pipeline pressures between 45 - 65 psi
Air ± 10% of setting with pipeline pressures between 50 - 55 psi
Air flow rate will vary proportionally with supply pressures outside 50 - 55 psi.
Total Fresh Gas Flowmeter:
Range and accuracy:
0 to 10 L/min ± 10% of full scale at STP,
calibrated with 50% O2 / 50% N2O gas mixture
0 to 10 L/min ± 15% of full scale at STP for all other gas mixtures
Resolution:
0.5 L/min from 0.5 - 2 L/min
1.0 L/min from 2 - 10 L/min
O2 flush (bypass):
at 55 psi (3.8 bar): max. 50 L/min
at 50 psi (3.4 bar): min. 35 L/min
Common Gas Outlet Pressure Limit: 13 psi (0.9 bar), maximum
128
Technical Data
Anesthetic Agent Vaporizer Interface
Dräger Vapor quick-change plug-in system for up to two anesthetic agent vaporizers.
The connections are automatically closed and sealed when the vaporizer is removed.
Dräger Halothane Vapor
Dräger Enflurane Vapor
Dräger Isoflurane Vapor
Dräger Sevoflurane Vapor
Datex-Ohmeda Devapor/D-Tec for Desflurane
See specific Instructions for Use manuals for technical data of anesthetic agent vaporizers.
Monitoring and Measurement Display
Paw
Ve
Range
Resolution
Accuracy
Airway pressure (numeric)
-20 to 99 cmH2O
1 cmH2O
±4%*
Airway pressure (wave)
0 to 99 cmH2O
Expiratory minute volume
0 to 99.9 L/ min
0.1 L/ min
±15%†
Expiratory tidal volume
0 to 1500 mL
1 mL
†
±15% or
±20 mL,
whichever is
greater
Condition
ATPS
‡
ATPS
‡
Note: For end-tidal values of Desflurane exceeding 12%, tidal and minute volume accuracies
may exceed ±15%
f
Breathing frequency
2 to 99 bpm
FiO2
O2 measurement in the main gas 10 to 100 vol.%
flow
±1 bpm
±1 bpm
1 vol.%
±3 vol.%
with reference to
ambient pressure
during calibration
Response time
Less than
25 seconds
Service life of O2 sensor cell
> 8 months at 25°C, 50% relative humidity, 50% O2 gas mixture
(or > 5000% hour O2)
* Max. ± 4% of the measured value or ± 2 cmH2O, whichever is greater.
† At standard test conditions per EN740 Annex DD and fresh gas flow = 2 times Ve.
‡
ATPS = Ambient Temperature Pressure Saturated Gas
129
Technical Data
Breathing System
Compact Breathing System
Volume: 2.8 L + bag
Compliance: 0.22 mL/cmH2O*
§
in automatic mode (Volume Control)
Absorber volume: 1500 mL
Resistance of Breathing System
5 L/min
30 L/min
60 L/min
Inspiratory
Resistance
0.5 cmH2O*
1.3 cmH2O*
2.8 cmH2O*
Expiratory
Resistance
0.7 cmH2O*
2.4 cmH2O*
4.8 cmH2O*
§
Compliance exclusive of patient hoses.
Note: Resistance tests in compliance with EN740-107.4.2.1
* cmH2O, Dry
Classification
II b
Conforming to Directive 93/42/EEC Appendix IX
UMDNS Code
10-134
Universal Medical Device Nomenclature System
Control Inputs Ranges
APL-Valve
MAN mode
5 - 70 cmH2O
SPONT mode 1.5 cmH2O
Pressure Required to Open a Wet Unidirectional Valve
Moist: 1.5 cmH2O
(Tested in accordance with EN740)
Pressure Generated by a Wet Unidirectional Valve
Moist: 3.1 cmH2O (Tested in accordance with EN740)
Low Oxygen Supply Pressure Alarm
Alarm limit
Alarm signal
LED indicator
130
Warning signal when the
pressure drops below
20 ± 4 psi
High priority alarm
(Warning)
The red LED indicator in
the O2 area of the gas
flow control interface will
flash until the O2 supply
is restored.
Technical Data
S-ORC (Sensitive Oxygen Ratio
Controller)
S-ORC is a control element which guarantees a minimum O2 concentration in the fresh gas flow. As from
a flow rate of approx. 200 mL/min., the N2O concentration in the fresh gas can be freely set between
0 and 75%.
During O2 shortage
S-ORC limits the N2O
concentration in the
fresh gas, so that the O2
concentration does not
drop below 23 vol.%.
N2O metering valve
open and O2 metering
valve closed or O2 flow
less than 0.2 L/min
S-ORC prevents
N2O flow
During N2O failure
O2 may still be
administered. No alarm.
Serial Interface
Type: RS - 232
Baud Rates: 4800, 9600, 19.2K
Parity: Odd, Even, None
Data Bits: 7 or 8
Stop Bits: 1 or 2
Protocol: Vitalink. Medibus
131
Diagrams
Diagrams
Figure 141. Gas flow diagram (Compact Breathing System)
Ventilator
setting
Pmax / Peep
Fresh Gas
Decoupling
Fresh gas
APL Bypass
APL Valve
MAN
Absorber
SPONT
Scavenging
132
Bag
O2 FLUSH
*
VAPOR MOUNT
OPTION
N2O GAUGE
CHECK VALVE
O2 GAUGE
CHECK VALVE
*
N2O YOKE
O2 YOKE
O2 YOKE
YOKE OPTION
FRESH GAS
INLET OPTION
TOTAL
FLOWMETER
O2 GAUGE
AIR GAUGE
N2O GAUGE
FLOW CONTROL
VALVE MANIFOLD
SORC
SORC BY-PASS ASM
FLOWMETER ASM OPTION
FLOW SENSORS
Diagrams
Figure 142. Schematic Diagram of Internal Gas Flow
* Note: The check valve is not installed on the Canadian machine.
133
Appendix - Daily and Preuse Checkout Form
Daily and Preuse Checkout Form
Before operating the Fabius GS, the following checkout verification form must be completed to
ensure that the machine is ready for use. Do not insert any additional components into or
modify the anesthesia system after the checkout procedure is started.
This is a recommended procedure. Follow your institution's policies for specific checkout
procedures.
Caution: If any check can not be carried out satisfactorily, the machine must not be used.
Call your local Authorized Service Organization or DrägerService at:
DrägerService
Draeger Medical, Inc.
3122 Commerce Drive
Telford, PA 18969
Tel: (215) 721-5402
(800) 543-5047
Fax: (215) 721-5784
i
Please note that this Daily Pre-use check list takes into
consideration all possible configurations of the Fabius
GS. The clinician need only use those areas that apply
to their specific Fabius GS configuration.
All checks must be carried out daily before equipment
is used. The person who carries out the checks must
be fully conversant with the Instruction for Use. Checks
marked with a P must be carried out before each
patient use. These pages should be removed and
copied to establish a daily record of machines checks.
Mark each function when checks have been
satisfactorily completed.
Fabius GS Serial
Number
Pre-conditions
❐
Inspection intervals for machine and
accessories are current
❐
Machine fully assembled and connected
❐
Monitors (O2, P, V, CO2, anesthetic agent)
(when present) switched on and functioning,
self test carried out satisfactorily
❐
System diagnostics for Fabius GS carried out
P
❐
Sampling line for gas monitoring (when
present) connected to Luer lock on the
Y-piece, correct anesthetic agent selected
P
❐
Desflurane vaporizer (when being used)
powered on
P
Checking the Medical Gas Connections
❐
Visually inspect all gas supplies from the
medical gas pipeline system and cylinders to
make sure that they connect properly and fit
securely.
❐
Verify that all medical gas pipeline supplies
are within acceptable pressure ranges.
❐
Open reserve gas cylinders (when present).
❐
O2 pressure more than 1000 psi (70 bar)
❐
N2O pressure greater than 600 psi (43 bar) if
present
❐
Air pressure greater than 1000 psi (70 bar) if
present
❐
Close reserve gas cylinders.
O2 Flush Function
❐
Press O2 flush: A strong flow of gas should
be emitted from the patient connection.
❐
Release O2 flush button: flow of gas from
patient connection stops.
Checking Reserve Power
P
❐
Verify that battery is fully charged. (If the
battery does not show full a charge, the
battery operation time is not guaranteed to be
45 minutes.)
iii
Checking the Flow Control/Metering System
❐
Activate ManSpont mode.
❐
Vapor 19.n, Vapor 2000 (Tec 5)
P
❐
Fastening; Latched down firmly and set
vertically
Fully open the O2 metering valve.
O2 flow of at least 10 L/min present.
P
❐
Handwheel; In zero position and engaged
❐
Fully open the N2O metering valve. N2O flow
of at least 10 L/min present.
P
❐
Filling level between min. and max.
P
❐
Interlock; Locking function OK (when present)
❐
Turn off the O2 supply. Remove the O2
connector and close the O2 cylinder valve.
The O2 Low Supply Pressure Alarm LED is
blinking. N2O does not flow.
P
❐
Key-indexed filling system; Sealing key or pin
inserted and closed tight. (when present)
Filler opening locked shut.
P
❐
Quik Fil or Funnel filling system; Locking
screw tight (when present)
❐
Restore the O2 supply: N2O flow is present.
❐
Set O2 metering valve to 1.5 L/min.
N2O flow = 3 L/min to 5 L/min
❐
Close the O2 metering valve:
No N2O flow.
❐
Open the AIR flow control valve. Air flow of at
least 10 L/min present.
❐
Close all metering valves.
Sensor Calibration
Remove O2 sensor housing from inspiratory
valve dome
❐
Calibrate O2 sensor
❐
Calibrate flow sensor
❐
Replace O2 sensor
P
❐
vertically
P
❐
P
❐
P
❐
Operational light lit
Selectatec™
P
❐
vertically
P
❐
P
❐
P
❐
Interlock; Locking function OK (when
present)
Checking the Gas Type
iv
❐
Set the O2 metering valve to approx. 3 L/min.
❐
Verify an O2 concentration indication of
approx. 100 vol.%.
❐
Close O2 metering valve.
Checking the Condition of CO2 Absorbent
P
❐
Color change is no more than half the
canister of CO2 absorbent.
❐
Desflurane Vaporizer (when present)
Leak Testing the Fresh Gas Circuit
Checking Ventilator Operation
Test once without the vaporizer and once with each
Dräger Vapor with the handwheel set to zero.
P
❐
Connect a breathing bag to the Y-piece to act
as test lung.
❐Go to Standby and press the Leak Test soft key.
P
❐
Press the Pressure Control key and confirm.
If the system leaks (i.e. pressure drops):
P
❐
Check that ventilation measurements are
displayed.
P
❐
Check that the ventilator piston is cycling.
P
❐
Monitor the operation of the inspiratory and
expiratory valve discs.
P
❐
Check that the breathing bag (test lung) on
the Y-piece is ventilating.
P
❐
Press the Standby key and confirm.
Follow the instructions on the screen.
•
Check that all plug-in, push-fit and screw
connectors fit tightly.
Replace any missing or damaged seals. If
necessary, call your local Authorized Service
Organization or DrägerService.
•
Inspiratory and Expiratory Valves
(Compact Breathing Systems)
Press the ManSpont key and confirm.
Set APL-valve to MAN position and adjust to
30 cmH2O.
Press O2 flush.
P
❐
Breathing bag for manual ventilation fills
P
❐
Inspiratory and expiratory valve discs move
freely when the breathing bag is squeezed
and released.
Pressure-Limiting Valve
(Compact Breathing System)
P
❐
Set APL valve to MAN and 30 cmH2O.
Set fresh gas flow to 20 L/min.
P
❐
Press the ManSpont key and confirm.
❐
When the pressure waveform on the
Breathing Pressure Trace window stabilizes
(e.g., a flat line), flip the APL-valve to SPONT
to release pressure.
P
P
❐
Peak pressure display on monitor reads
24 to 36 cmH2O.
Monitors
The alarm function can be tested by setting alarm
limits to levels that are certain to trigger an alarm.
Check the alarm limit settings. The monitor alarm
limits are automatically set to a default configuration
when the SYSTEM POWER switch is turned on.
Check these settings and adjust them if necessary.
Alarm limits can be adjusted at the beginning of or
during a procedure. Also, make sure that any external
monitors (if any) are connected properly.
Test the alarm functions for all monitors. Simulate
alarm conditions and check for appropriate alarm
signals.
❐
Test the O2 monitor and alarm module.
❐
Test the volume monitor and alarm module.
❐
Test the pressure monitor and alarm module.
❐
Press the Standby key and confirm.
v
Additional Monitors (when present)
❐
Check the CO2 monitor and alarm module.
❐
Check the anesthetic agent monitor and
alarm module.
P
❐
Verify that
• all vaporizers are off (the handwheels are
set to zero),
• the APL Valve is set as desired,
• all flowmeters indicate 0,
• the patient suction is level adequate, and
• the breathing system is ready to use (the
bag is in place and all hoses are
connected properly)
Anesthetic Gas Scavenging System
P
P
P
P
Before Connecting to Patient
❐
Check the hose connections.
❐
Adjust the flow regulator to place the float
between the "Minimum" and "Maximum"
marks.
If any check can not be carried out satisfactorily,
the machine must not be used.
❐
Press and hold the O2 flush button and verify
that airway pressure is < 10 cmH2O with
Y-piece occluded.
Daily Checkout Signature
❐
Close all flow control valves on the machine,
with Y-piece occluded, and verify that airway
pressure is > -0.5 cmH2O .
Manual Ventilation Bag for Emergency
Ventilation (when present)
Check that the bag is functioning correctly by
pumping manually.
❐
When the bag is squeezed, air must audibly
and tangibly flow out of the mask cone; when
the bag is released, it must rapidly recover its
original shape.
❐
Block off the mask connector (cone) with the
ball of your thumb: you should only be able to
squeeze the bag a little.
Date
Preuse Checkout Signature
Name
Date
Name
Date
Name
Date
vi
❐
Name
Name
Name
Date
Date
Name
Name
Date
Date
Name
Name
Date
Date
Name
Name
Date
Date
Name
Name
Date
Date
Name
Name
Date
Date
vii
Name
Name
Date
Date
Name
Name
Date
Date
Name
Name
Date
Date
Name
Name
Date
Date
Name
Date
Date
Name
Name
Date
Date
viii
Name
c
0344
Directive 93/42/EEC
Concerning Medical Devices
The CE mark applies to
Fabius GS Anesthesia Machines
equipped with gas color codes
in compliance with EN 1089-3.
Dräger Medical, Inc.
3135 Quarry Road
Telford, PA 18969
USA
(215) 721-5400
(215) 721-9561 (Sales Fax)
(215) 723-5935 (Service Fax)
http://www.draegermedical.com
EC Representative:
Dräger Medical AG & Co. KGaA
Germany
Moislinger Allee 53 – 55
D-23542 Lübeck
(451) 882 - 0
FAX(451) 882-2080
http://www.draeger.com

Operator`s Instruction Manual

Transcription

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